Study shows dramatic shift to prostate cancer treatments that match risk

CANCER DIGEST – July 27, 2015 – In the first study to document updated treatment trends, researchers found that from 2010 to 2013, 40 percent of men with low-risk prostate cancer opted for active surveillance, in which the disease is monitored closely with blood tests, imaging studies and biopsies. Treatment is deferred unless these tests show evidence of progression.

That is much higher than the 10 percent of low-risk prostate cancer patients who pursued active surveillance in the years from 1990 through 2009. Rates for radiation therapy for this low-risk group have also slipped since 1995. The analysis was based on an ongoing study called, Cancer of the Prostate Strategic Urologic Research Endeavor or CaPSURE Registry. The study published in the July 7, 2015 JAMA.

In men with intermediate-risk disease, 9.7 percent were treated with hormone therapy in 1990 to 1994, versus 3.8 percent in the period of 2010 to 2013. Among those with high-risk disease, 30 percent underwent hormone treatment between 1990 and 1994 compared to 24 percent between 2010 and 2013.

Surgery for men aged 75 or older with low-risk cancer increased to 9.5 percent and for these men with intermediate-risk cancer surgery increased to 15 percent. There was no increase in surgery among those with high-risk cancer, among whom hormone therapy held steady at 67 percent.

The authors suggested that overall men with prostate cancer were receiving more appropriate treatment that matched the level of risk.

Read more …