Prostate cancer: Treat or don’t treat?

"This treatment may cause more harm than good for these individuals," says Oliver Sartor, "especially patients with slow-growing tumors who are not likely to die of their disease." (Credit: iStockphoto)

A widely used treatment for prostate cancer may cause more harm than good for some patients, a new study reports.

For decades, many men diagnosed with prostate cancer were treated with androgen deprivation therapy (ADT), injections that suppressed testosterone production.

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A new study published in the journal Onco Targets and Therapy shows this is the wrong approach for selected men with localized disease, as it provides no added survival benefit and may be associated with other serious health issues.

“Men with advanced disease, or certain men with aggressive disease confined to the prostate gland, are potential ADT candidates,” says Oliver Sartor, medical director of the Tulane University Cancer Center.

“Testosterone suppression can increase radiation cure rates for certain aggressive cancers, and it is standard of care for metastatic disease.”

For years, though, many doctors used ADT for men with low-grade, prostate-confined cancers.

More harm than good

“We now have good evidence this treatment may cause more harm than good for these individuals,” Sartor says, “especially patients with slow-growing tumors who are not likely to die of their disease.”

The research shows ADT can potentially lead to health issues, including hot flashes, loss of libido, fracture risk, muscle loss, fatigue, depression, diabetic risk, erectile dysfunction, and weight gain.

Of the 240,000 new cases of prostate cancer diagnosed in the US each year, more than half are early stage and low risk.  So what’s the bottom line?

“Many men diagnosed with prostate cancer may not need to be treated,” Sartor says. Instead, “active surveillance” may be a better option for men with low-grade, localized disease.

Source: Tulane University