Aggressive Prostate Cancer Treatment Despite Guidelines

Aggressive Prostate Cancer Treatment Despite Guidelines
When men are diagnosed with prostate cancer and have a life expectancy of less than 10 years, national guidelines recommend "watchful waiting" instead of treatment, as patients are unlikely to see added benefits from aggressive treatment, such as radiation or surgery, within 10 years. Regardless of these guidelines, a study from the University of California, Los Angeles, shows that more than half of men with a low life expectancy are treated with radiation therapy. Dr. Timothy Daskivich led the research effort, which involved analyzing health histories of over 96,000 men diagnosed with early-stage prostate cancer and listed in the Surveillance, Epidemiology, and End Results-Medicare database. Approximately half of the men had life expectancies less than 10 years, and the majority were treated with surgery, radiation, or brachytherapy. This may be problematic, as aggressive treatments can lead to poorer quality of life. "Life expectancy is poorly integrated into treatment decision-making for prostate cancer, yet it is one of the primary determinants of whether a patient will benefit from treatment with surgery or radiation," said Dr. Daskivich in a news release from UCLA. "Because these treatments have side effects such as erectile dysfunction, urinary incontinence, and bowel problems, it is crucial for men with limited life expectancies to avoid unnecessary treatment for low- and intermediate-risk prostate cancer." The one exception was men 80 years and older, of whom 24% were treated aggressively. Men between the ages of 66 and 69 years were treated aggressively 68% of the time, men between the ages of 70 and 74 were treated aggressively 69% of the time, and men between the ages of 75 and 79 were treated aggressively 57% of the time, predominantly by radiation
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