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New studies show that when treating prostate cancer, less may be more

Prostate cancer

Over the past six months, there have been several articles written about the treatment of prostate cancer. The results of these studies should change the standard of care for those dealing with prostate cancer.

The Prostate Testing for Cancer and Treatment (ProtecT) trial, published in the New England Journal of Medicine, looked at the benefit of screening and treating men with mostly low-risk prostate cancer. In this randomized trial, more than 82,000 men aged 50-69 who were screened with a PSA. Out of that group, 2,664 men had prostate cancer. Of that group, 1,643 men with mostly low-risk cancer were randomized to have surgery, radiation or active surveillance.

After 10 years of follow-up, they found that there was no difference in outcomes among those who had surgery, radiation or surveillance.

Researchers determined:

  • There was a low risk of dying from prostate cancer.
  • 50 percent of the men on active surveillance ended up getting treatmen.
  • Surgery for prostate cancer had a lot more side effects than those having active surveillance or radiation treatments.

The main takeaway from this study is that the risk of dying from low-risk prostate cancer is very low in patients who are screened, so active surveillance is a very good option. Surgery used to be the standard of care, but now radiation will be a second standard option.

Reducing radiation

The next few studies that have recently been published look at reducing the number of radiation treatments.

In the past, people have gotten on average 37-48 treatments when receiving radiation for prostate cancer. The recent studies have compared the longer course of radiation to two types of shorter radiation. 

One type is called hypofractionated radiation, where a patient receives between 19 and 27 treatments.

Recent studies have shown that the shorter course of radiation works just as well as the longer courses of radiation.

The other type is called extreme hypofractionated radiation, where a patient receives five treatments. The preliminary five- to eight-year results are very promising and may lead to a new standard of care. Via Christi offers this option through its CyberKnife Center in Wichita.

About David Bryant MD

David Bryant, MD, is an oncologist with the Ascension Via Christi Cancer Center.