A new study in the early online edition of Cancer concluded that treating older men with early-stage prostate cancer who also had other serious health problems with aggressive therapies such as surgery or radiation therapy does not help them live longer and may be detrimental.
The retrospective study followed more than 140,500 men aged 68 and older diagnosed with early stage prostate cancer between 1991 and 2007. Men were followed for 15 years after diagnosis and the Charison Index that can predict 10 year mortality for a patient who has a range of other health problems was used.
A prostate cancer patient with diabetes may score 1 on the index, whereas a man with multiple or more severe health problems might score a 3 or higher. Findings showed that men with a Charison index score of 0,1 or 2 who were treated with surgery or radiation therapy had a lower risk of dying of prostate cancer compared to men receiving no treatment.
However, men with scores of 3 or higher did not have a reduction in risk of death from cancer with aggressive treatment because they did not live long enough to benefit from it and were more likely to die from something else. They said men who also had multiple medical conditions such as a history of heart attack, chronic obstructive pulmonary disease and diabetes in combination did not live longer after aggressive treatment compared with men receiving no treatment. They were also at risk of side effects such as impotence, urinary incontinence and bowel problems that can result from surgery and radiation treatment.
Researchers said, “The guidelines suggest the men with life expectancies of less than 10 years shouldn’t be treated aggressively, but life expectancy is difficult to measure accurately. This data clearly defines a subset of patients who should avoid therapies that will only cause them problems they don’t already have.”