Prostate Cancer Therapy May Not Help
Hormone Therapy Doesn't Increase Survival in Older Men With Early Prostate Cancer
Lu-Yao and Brawley suggest that these older men would have done just as well if their cancers had never been detected. Brawley notes that many of these men likely underwent continued prostate cancer screening with PSA tests. Others probably had possible prostate abnormalities detected by a urologist.
Regardless of how they got there, all these older men must have agreed to undergo prostate biopsies. And that may not have been the result of a fully informed decision, says Simon Hall, MD, head of urology at New York's Mount Sinai School of Medicine.
"You have to have a discussion with an older man before he has a prostate biopsy. You have to ask, 'Do you really want to open Pandora's Box?'" Hall tells WebMD. "Most patients with localized prostate cancer are not going to die from their disease in the first 10 years anyway. It is a legitimate question whether to screen patients this old, and whether urologists should biopsy older patients based on just a knee-jerk reaction."
Hall says there are very few men he would treat with hormone therapy alone.
"A lot of these older men are at low risk and don't need any treatment at all," he says. "It doesn't seem hormone therapy would make a difference, so why put them through the significant side effects and the cost?"
All of the experts who spoke with WebMD noted that the current study findings do not apply to younger men who might receive androgen-deprivation therapy in combination with surgery or radiation. Such men may benefit from hormone therapy.
Lu-Yao and colleagues report their findings in the July 9 issue of The Journal of the American Medical Association.