70% of Men Don’t Need Aggressive Treatment for Prostate Cancer

According to a study in the Journal of the American Medical Association (Albertsen et al., JAMA. 2005 May 4) 70% of men don’t need aggressive treatment for prostate cancer.

The study followed 767 men aged 55 to 74 diagnosed with clinically localized prostate cancer over 20 years. None of the men underwent surgery. Instead, the men were treated with observation, or immediate or delayed hormone therapy.

The main conclusion of the study was that annual mortality rates from prostate cancer remain stable after 15 years from diagnosis and the study authors note that their data “… does not support aggressive treatment for localized low-grade prostate cancer.”

By the end of the study 717 of the 767 men had died. During the study period, only 29% of the men died from prostate cancer. Sixty-one percent of the men died from causes other than prostate cancer, 6% of the men were still alive, and 4% of the men died from undetermined causes.

The study stratified the men according to the Gleason scores of their prostate cancer and then determined death rates depending on the Gleason scores. Gleason scores are determined by looking at prostate cancer under the microscope. The higher the Gleason score, the worse the prognosis. Over 20 years time:

7% of men with Gleason scores 2, 3, or 4 died from prostate cancer.
14% of men with Gleason scores of 5 died from prostate cancer
27% of men with Gleason scores of 6 died from prostate cancer
45% of men with Gleason scores of 7 died from prostate cancer
66% of men with Gleason scores of 8, 9, or 10 died from prostate cancer.

The most common Gleason score among the men in this study was 6.

The authors write that, “… a significant number of prostate cancers identified by PSA testing are unlikely to be clinically significant.” The authors also say that, “… men with well-differentiated tumors rarely die from their disease and that men with poorly differentiated tumors frequently die within 5 to 10 years of diagnosis, often despite aggressive interventions.”

“This is the most recent in a long line of watchful waiting studies for prostate cancer,” says Dr. Bradley Hennenfent, author of the new book, “Surviving Prostate Cancer Without Surgery.” “This study once again points out that claims of prostate cancer surgery curing the majority of men are untrue, because prostate cancer is slow growing in the majority of cases. You can’t claim a high cure rate for prostate cancer surgery, when in fact, most men with prostate cancer don’t need to be cured.”

“In addition,” says Dr. Hennenfent, “a true cure returns you to normal health. The radical prostatectomy always makes men sterile and causes sexual dysfunction; it also commonly causes a smaller penis, impotence, incontinence or urinary strictures. It’s always a sacrifice, never a cure.”

Dr. Hennenfent has seen five uncles suffer from prostate cancer and has seen them treated by various methods. He co-founded the Prostatitis Foundation (www.Prostatitis.org), founded the Epididymitis Foundation (www.EpididymitisFoundation.org), and founded the Acoustic Neuroma Foundation (www.AcousticNeuromaFoundation.org). He previously published "The Prostatitis Syndromes."

"Surviving Prostate Cancer Without Surgery" can be found in fine bookstores everywhere. Biblio Distribution (800-462-6420) and Roseville Books/Rayve Productions (888-492-2665) distribute the book. It’s $19.95, a trade paperback, 334 pages, 34 chapters, ISBN Number: 0-9717454-1-2, and was published January 15, 2005. Twenty-seven illustrations and cartoons are included within the book, which also includes an extensive index.

Website: www.SurvivingProstateCancerWithoutSurgery.org.
Contact: Arnold@RosevilleBooks.com