Veterans with non-aggressive prostate cancer are rejecting aggressive treatments following the advice of international medical experts, but without increasing the risks, a new study suggests.
Low-Risk Prostate Cancer Does Not Need Immediate Treatment
The study was led by researchers at the New York University School of Medicine, NYU's Perlmutter Cancer Center, and the Manhattan campus of the VA NY Harbor Healthcare System.
The large study noted the increasing numbers of patients with low-risk prostate cancer who are electing to practice active surveillance of the disease rather than immediate treatment. Patients have to undergo tests and check-up on a regular basis to ensure that cancer remains at a safe stage. If it gets worse, that is the only time that a treatment is considered.
The study published Tuesday in the The Journal of the American Medical Association looked at the medical records of 125,083 veterans diagnosed with prostate cancer from 2005 to 2015.
In 2005, the study found that only 27 percent of men under 65 years old opted out of cancer treatments while 4 percent received active surveillance. Those figures jumped to 72 percent and 39 percent in 2015, similar to the numbers for participants over the age of 65.
"Our study shows that the Veterans Affairs health care system has done a good job over the last decade in adopting 'conservative management' of men diagnosed with early-stage disease, with many men choosing active surveillance as an alternative to immediate therapy," says Stacy Loeb, MD, MSc, study senior investigator and urologist.
Overtreating Cancer Might Be A Thing Of The Past
The study highlights the importance of active surveillance rather than overtreating a malignancy that may otherwise be harmless. The increase in veterans opting out of harmful therapy or radiation brings hope that other American men will also see the benefits of active surveillance.
"Remember that until 2010, a man diagnosed with prostate cancer was told to get your prostate out, next week at the latest," said Otis Brawley, the chief medical officer of the American Cancer Society.
Brawley, who was not involved in the study, has long been advocating against the risks of overtreating prostate and breast cancer. He is hopeful that five years from now, the whole country will see that 70 percent of men with low-risk cancers will not pursue an immediate treatment for low-risk tumors.
That figure will be possible with the proliferation of knowledge about active surveillance to both patients and doctors who might still suggest an immediate surgery following a diagnosis.