Prostate cancer: controlled instead of treated

All content is checked by medical journalists.

The diagnosis of prostate cancer initially comes as a shock to many sufferers. But especially with tumors in the prostate gland, it depends a lot on which type of cancer a man has. Less aggressive prostate tumors - even if left untreated - are very rarely fatal, as new figures now show.

Prostate cancer is considered a cancer with a relatively good prognosis. Not every tumor has to be treated, but all should be carefully observed - this was shown by Dr. Ballentine Carter from Johns Hopkins University in Baltimore and his team were once again impressive in their study.

To do this, they included the data of 1,300 men in their study who were diagnosed with a tumor with little or very little potential for aggression. At the start of the study, the mean age was 66 years. The researchers followed the patients for up to 15 years.

Cancer, not a death sentence

"Our goal was to show patients with less aggressive tumors that the cancer often does them no harm at all," the experts write in their publication. They did it: During the entire study period, only two men (0.15 percent) died of prostate cancer. Much more participants, a total of 47 (3.6 percent), succumbed to other causes of death, such as cardiovascular disease. The researchers calculated that the risk of dying from causes other than prostate cancer was 24 times higher than from the tumor.

After 15 years, the cancer-specific survival rate was 99.9 percent. Most of them - all but five - were also free of metastases, descendants of the tumor that settle elsewhere on the body.

Altered tumors

What all the test subjects had in common was that they were examined very closely, namely annually. For this purpose, tissue samples were taken annually in order to assess the aggressiveness of the cells. The researchers analyzed the frequency of certain proteins that are produced by a so-called PTEN gene. In around a third of the study participants, the tumors changed in such a way that they had to be classified as more aggressive.

The researchers recommended these patients to undergo medical treatment. In contrast, if the tumor did not change, they did not offer such advice.

Treat or not?

Those affected who were diagnosed with slowly growing cancer had to make a difficult decision: should they wait or undergo surgery or radiation with the chance of a complete cure?

During the study period, 109 men opted for treatment, although the status of their tumor did not change significantly. Of the men whose tumors were classified as more aggressive, 361 opted for cancer therapy.

Balancing act

"It is not easy to find the balance between too few and too many treatments", according to the American scientists, "but our study data should help to be able to make better decisions". Specifically, this means: The experts recommend that men with low-aggressive prostate cancer have regular medical examinations by specialists. They advocate that not everyone is treated immediately - possibly even unnecessarily.

Men's cancer

Prostate cancer is the most common cancer in men. Over 36,000 of them receive the diagnosis annually in Germany. The earlier a tumor is discovered, the better it can be treated. However, there are also risks associated with any therapy. Having surgery, for example, can cause erectile dysfunction or incontinence. Therefore, the benefits and disadvantages should always be carefully weighed. (vv)

Source: J. Tosoian et al. 2015. Intermediate and Longer-Term Outcomes From a Prospective Active-Surveillance Program for Favorable-Risk Prostate Cancer. Journal of Clinical Oncology. 10.1200 / JCO.2015.62.5764

Tags:  nourishment pregnancy birth news