Conservative treatment: a better option for some prostate cancer patients

23 Mar 2015

Results from a population-based study from investigators at Rutgers Cancer Institute (New Jersey, USA) show favorable survival outcomes among patients with low-risk prostate cancer treated with conservative management initially.

This study showed that men diagnosed with prostate cancer beginning in the early 1990's had significantly improved survival compared with patients whose cancers were diagnosed in prior decades.

Dr. Grace Lu-Yao, its lead author, notes that this study examines data for an additional five years and can "provide a more complete picture of potential outcomes for patients who have a life expectancy greater than 10 years."

A trial based on a population often omitted from studies

The new research examined 33,137 patients aged 65 or older who were diagnosed with early-stage (T1 or T2) prostate cancer from 1992 through 2009 and received conservative management (no surgery, radiotherapy, cryotherapy or androgen deprivation therapy) within the first six months of diagnosis.

The study is considered highly innovative as the population included is broadly representative instead of focused on specific geographic areas or institutions. Lu-Yao also notes the study provided information on more than 10,000 men aged 75 or older -- a population which is often omitted from studies. But they also caution that because the men in the study were older than 65, the data may not apply to younger patients.


Stable or lower mortality rates

After the analysis of the data, the investigators reported that:

  • Men aged 64-74 with a Gleason score (a grading system that indicates how likely a tumor will spread) of between 5 and 7 had a risk of 5.7% of dying from prostate cancer over a 15-year period as compared to men 75 and older, whose risk was 10.1%.
  • For men with the highest level Gleason scores (between 8 and 10), 15-year prostate cancer mortality rates were 22% for men aged 65-74 and 27% for men 75 and older.
  • Mortality rates remained relatively stable from 6 to 16 years following diagnosis.
  • After the examination of the possibility of comorbid diseases, the researchers found that those who did have other health problems had a lower risk of dying from prostate cancer due to deaths from competing health issues.

“A more current representation of outlook survival”

"The proportion of men diagnosed with localized prostate cancer who choose to have conservative management is relatively small but, is on the rise. The information provided by this long-term study will help facilitate treatment decisions," says Lu-Yao. "Our study, which includes data from the PSA testing era, is a more current representation of outlook survival for this population."

Lu-Yao indicates the study could help change the conversation between patient and physician. "By having additional data available to support conservative management, doctors can further educate their patients about survival outcomes and possibly help avoid treatments that may put the patient at risk."

Source: Science Daily
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