Men With Low-Risk Prostate Cancer Usually Get Treatment, Despite Side Effects

Widespread PSA testing has led to a prostate cancer epidemic. Overtreatment of the many low-risk cancers detected has undercut the public health gains.

Most men with low-risk prostate cancer get aggressive treatment, even though the therapies carry big risks, a new study finds.

Surgical removal of the prostate and radiation therapy can cause incontinence and impotence. For men with prostate cancer that grows slowly, the researchers who analyzed data on more than 124,000 men with prostate cancer say the treatments may cause more harm than good,

The problem stems from the widely used PSA blood test, which can trigger a biopsy and cancer diagnosis. Researchers found that about 1 in 7 men diagnosed with prostate cancer had a low PSA -- below 4 and considered the upper limit of normal.

Most of these men turned out to have low-risk, slow-growing cancers, yet the great majority of them got aggressive treatment anyway. The findings appear in the Archives of Internal Medicine.

The researchers say that many American men with prostate cancer aren't likely to benefit from this aggressive treatment. Instead, their cancers could be monitored and many would never pose a threat.

An accompanying editorial calls the nation's experience with the PSA test a "cautionary tale." More bluntly, the authors of the commentary write, "Unfortunately, some 2 decades into the PSA era, the promise of early detection has been tarnished."

Widespread PSA testing and early identification of prostate cancer have led to an epidemic. Aggressive treatment of the many low-risk cancers found is the bigger problem because men who probably won't get many benefits can suffer life-changing side effects. Copyright 2010 National Public Radio. To see more, visit http://www.npr.org/.

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