Thursday 25 May 2006
New research from The Institute of Cancer Research strongly suggests that the majority of men diagnosed with low-grade prostate cancer do not need to undergo the radical treatment currently used.
This latest research from The Institute of Cancer Research shows that the removal of the prostate is very unlikely to increase overall survival for men with low-grade prostate cancer.
Prostate cancer is the most commonly diagnosed male cancer in the UK with nearly 32,000 new cases each year and around 10,000 deaths.
At present, men diagnosed with the disease may undergo radical treatment (either surgery to remove the prostate or radiotherapy) alternatively they may simply be managed by observation (‘watchful waiting’). The drawbacks of radical treatment are well known and include incontinence and impotence. However, the overall benefits of radical treatment are uncertain.
The modelled data published in the British Journal of Cancer* predict that only about 1% of men (aged 55 - 59) with low-grade, screen-detected prostate cancer would die from their disease within 15 years, even without treatment. However, men in the same group with high-grade prostate cancer should benefit from treatment. The model predicts that without treatment up to 68% of these men could die from prostate cancer.
Dr Chris Parker from The Institute of Cancer Research, who is funded by Cancer Research UK and the NCRI Southern Prostate Cancer Collaborative, commented:
“Most men with prostate cancer detected by PSA screening will live out their natural span without the disease ever causing them any ill effects. The decision whether to have radical treatment can be tremendously difficult for the patient. The results of trials looking at the long-term survival benefit of radical treatment are several years away. So, this new information on the potential impact of treatment on overall survival will be of great interest to men faced with this decision.”
“We are currently trialling a new prostate cancer management technique called ‘Active Surveillance’ which aims to target treatment only to those men who need it. Patients are closely monitored and the choice between radical treatment and continued observation is based on evidence of disease progression. Encouraging preliminary results were presented recently and we eagerly await longer term results.”
This research further highlights the need for a test to distinguish prostate cancers which are fast-growing and aggressive (tigers) which require treatment from the slow-growing cancers (pussycats) that do not require treatment. Institute researchers have made great progress in this area. Since discovering the E2F3 gene as a marker of prostate cancer aggressiveness they have been committed to developing this test.
June is the 9th Annual Everyman Male Cancer Awareness Month. Everyman aims to raise £500,000 in June to fund research fund vital research in to male cancers at The Everyman Centre - Europe’s only dedicated male cancer research centre
* Volume 94, Issue 10 - www.nature.com/bjc
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Notes to Editors
- Lead time estimates in men diagnosed aged 55-59 years were 14.1, 9.3 and 5.0 years for men with Gleason scores < 7, 7 and > 7, respectively, assuming biennial screening with 100% attendance.
- Central estimates of 15-year prostate cancer mortality for conservative management of screen-detected prostate cancer ranged from 1% for Gleason scores < 7, 7-20% for Gleason score 7, and 23-68% for Gleason scores > 7.
- For men aged 55-59 years at diagnosis, the predicted absolute 15-year survival benefit from curative treatment was 0%, 11% and 23% for men with Gleason scores < 7, 7 and > 7, respectively. Estimates of the survival benefit of radical treatment were relatively insensitive to values of key parameters.
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