Aggressive Treatment of Low-Risk Prostate Cancer Common

A new study in the Archives of Internal Medicine shows that men who receive a diagnosis of low-risk prostate cancer commonly undergo unnecessarily aggressive treatment such as radiation or removal of the prostate.

The study examined the patterns of risk and treatment of more than 120,000 men and found that 14% of the group had a prostate-specific antigen (PSA) of 4.0 ng/mL. Slightly more than half these men had low-risk cancer. Yet, more than three fourths underwent treatment that was disproportionately aggressive in relation to the severity of the cancer. One third underwent radiation therapy while more than 40% had their prostates removed.

PSA is generally not considered worrisome unless it exceeds 4.0 ng/mL. The study recommends that other factors be used to determine the course and level of treatment. These include the Gleason score and other factors such as prostate size and biopsy findings. The researchers who conducted the study recommend a technique called active surveillance, which consists of monitoring the disease by periodically checking PSA levels and performing biopsies and digital rectal exams. The patient is then better able to make an informed decision as to course of treatment without electing for radical therapies that are likely unnecessary.