‘Watchful waiting’ for older men effective

More conservative treatment, or watchful waiting of localized prostate cancer may be why outcomes have improved, U.S researchers said.

Grace L. Lu-Yao of the Cancer Institute of New Jersey and the University of Medicine and Dentistry of New Jersey’s Robert Wood Johnson Medical School in Piscataway, N.J., and colleagues said the study was based on data from a population-based study that included 14,516 men who were not treated with surgery or radiation for six months after their Stage 1, or Stage 2 prostate cancer diagnosis. They were tracked for about eight years.

The study, published in the Journal of the American Medical Association, found overall and prostate cancer-specific survival rates are higher for men over the age of 65 diagnosed from 1992-2002 with localized prostate cancer — compared with men diagnosed in the 1970s and 1980s.

The researchers attribute 60 percent to 74 percent lower prostate cancer death rates in older men to a number of factors.

Aggressive treatment for prostate-cancer patients age 65 and older does not seem to significantly improve survival, the study said.

The substantial improvement in survival that we observed in our study compared with previous reports might be explained, in part, by additional lead time, overdiagnosis related to prostate-specific antigen testing, or grade migration, among other factors, the study authors said in a statement. Prostate-specific antigen testing identifies disease 6-13 years before it presents clinically.