Some With Prostate Cancer May Not Get Best Advice
Doctors suggest widely varying treatments; second opinion vital, experts say
He noted that side effects of surgery or radiation include impotence, incontinence and rectal bleeding. "So, you should not just go with the first person who diagnoses you," D'Amico said.
For the study, Hoffman's team collected data on a little more than 2,000 men, aged 66 and older, diagnosed with low-risk prostate cancer from 2006 through 2009. The diagnosis was made by urologists, the researchers noted. Among these men, 80 percent received treatment and 20 percent were observed.
In the second report, a team led by Dr. Grace Lu-Yao, a professor of medicine at the Rutgers Cancer Institute of New Jersey and Robert Wood Johnson Medical School in New Brunswick, N.J., found that hormone treatment did not improve survival in men with prostate cancer that had not spread beyond the prostate.
"The data do not support the practice of using hormone therapy as the sole therapy for elderly patients with localized prostate cancer," Lu-Yao said.
Because hormone therapy is associated with side effects such as osteoporosis, diabetes and decreased muscle tone, doctors must carefully consider the reasons for using this treatment as the primary treatment for older men with low-risk localized prostate cancer, she said.
Using federal government data, Lu-Yao's team collected information on almost 67,000 Medicare patients, diagnosed between 1992 and 2009. These men had not had surgery or radiation within 180 days of diagnosis, the researchers said.
During an average of 110 months of follow-up, hormone therapy was not associated with improved survival, the researchers found.
In fact, 15-year survival in men, whether their cancer was fast- or slow-growing, didn't differ if they received hormone therapy or not, the researchers found.
Survival among men with slow-growing cancer was about 90 percent with or without hormone therapy. For men with fast-growing cancer, survival was about 78 percent among both men treated with hormone therapy and men who weren't.
Both studies were published online July 14 in the journal JAMA Internal Medicine.