WEDNESDAY, Nov. 12, 2024 (HealthDay News) — Overtreatment of prostate cancer is increasing in the United States among men with limited life expectancy, a new study reports.

Procedures such as radiation therapy and prostate surgery are used more often in these men, causing side effects like incontinence and impotence without adding extra years to their lives, researchers found.

Two-thirds of men with intermediate-risk prostate cancer and nearly half of men with high-risk prostate cancer receive treatment that is often harmful and unnecessary, they added.

“We found this trend surprising,” said the lead researcher Dr. Timothy Daskivitchdirector of urologic oncology research at Cedars-Sinai Medical Center in Los Angeles.

“Prostate cancer patients with a life expectancy of less than five or ten years were subjected to treatments that could take up to a decade to significantly improve their chances of surviving the cancer, despite guidelines recommending against it. treatment,” Daskivich added in a statement from Cedars-Sinai. release.

This trend goes against efforts promoting “active surveillance” of prostate cancers in men, the treatment of which would unnecessarily harm their quality of life.

This “watch and wait” approach is recommended for all prostate cancer patients who are likely to die of another cause, whether they are men with low-risk cancer and slow-growing or those with more advanced cancer but only a few years of life. left, the researchers said.

“The use of active surveillance has increased over the past 15 years for men with low-risk prostate cancer, and it is now the most common treatment for these men,” Daskivich said. “This approach allows these patients to avoid the risks of urinary incontinence, erectile dysfunction and other potential side effects of surgery and radiation therapy. »

For this study, researchers analyzed medical data from nearly 244,000 men diagnosed in VA hospitals with prostate cancer between 2000 and 2019.

The results show that radiation therapy or surgery in men with low-risk prostate cancer decreased from 37% to 15% during this period, as recommended.

However, treatment of intermediate-risk prostate cancer increased from 38% to 60%, according to researchers.

And among men with an average life expectancy of less than five years, treatment for high-risk prostate cancer increased from 17% to 47%.

Radiation therapy is most often used in the unnecessary treatment of prostate cancer and is used 80% of the time, researchers found.

The use of radiotherapy increased from 16% to 39% among men with a life expectancy of less than five years, according to the study.

The new study was published November 11 in the journal JAMA Internal Medicine.

To avoid overtreatment, Daskivich and his team proposed a “trifecta” method for discussing prostate cancer prognosis with patients.

In this method, the doctor would discuss the likelihood of dying from cancer with or without treatment, taking into account the patient’s individual life expectancy.

“Our goal is to encourage clinicians to incorporate longevity into the discussion of best treatment options so that prostate cancer patients with limited life expectancies can make informed choices,” said Daskivich. .

“A patient can receive this data and choose to pursue surgery or radiation therapy regardless of a limited likelihood of benefit. Another patient might take a different path,” Daskevich added.

“Every individual is different and statistical averages regarding lifespan, treatment effectiveness and cancer risk cannot predict outcomes with certainty,” Daskivich concluded. “But patients should have the opportunity to make informed decisions with the best information possible.”

More information

The American Cancer Society has more to say about prostate cancer.

SOURCE: Cedars-Sinai Medical Center, press release, November 11, 2024