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Report Questions Aggressive Cancer Treatment For Men Unlikely To Die Of Prostate Cancer

Elizabeth Allen, UTHSC-SA

A new report in the Journal of the American Medical Association said too many men have been getting aggressive treatment that they don't need for prostate cancer. The study suggests the side effects of treatments outweigh their benefits.

The side effects of surgery and radiation treatment for prostate cancer can include sexual dysfunction and urinary problems, and now researchers say those treatments may be too radical.

Dr. Ian Thompson, director of the San Antonio Cancer Therapy and Research Center, said the trend to treatment has often been dictated by an oversimplification of the cancer diagnosis.

He said in the early 1980s, before the Prostate-Specific Antigen (PSA) test, most men diagnosed with prostate cancer were in advanced stages of the disease. The advent of the PSA test meant earlier diagnosis, but the test also may have resulted in a collective overreaction.

"It’s finding these prostate cancers that probably really shouldn’t be called cancer, and thinking of them like cancers with a capital 'C' and treating them all," Thompson said.

Thompson said many of the men diagnosed can simply be observed with a high degree of safety, and that’s better than some of the side effects, including those from hormone treatments to lower testosterone.

"It can be fatigue, loss of muscle mass, weakening of the bones and weight gain, as well as the menopausal type of hot flashes. And in the brain there’s a loss of libido, sex drive and some cognitive function issues as well," he said.

The JAMA article suggests a more tempered treatment protocol, with surveillance being the primary path for most men. Thompson said 75 percent to 80 percent of men will get prostate cancer, but only 2 percent to 2.5 percent will die from it.

Eileen Pace is a veteran radio and print journalist with a long history of investigative and feature reporting in San Antonio and Houston, earning more than 50 awards for investigative reporting, documentaries, long-form series, features, sports stories, outstanding anchoring and best use of sound.