According to the American Cancer Society, 234,000 men will be diagnosed with prostate cancer this year, and 27,350 will die from it, but researchers say that as many as half of men diagnosed with low-risk prostate cancer undergo surgery or radiation therapy unnecessarily.
The researchers from the University of Michigan Comprehensive Cancer Center, say that a policy of watchful waiting or "expectant management" i.e. regular checkups to see if treatment is necessary, is a more valid option for men with early-stage prostate cancer.
Dr. John T. Wei and his associates say that just as a failure to treat a potentially lethal prostate cancer is generally considered inappropriate, aggressive treatment of slow growing cancers may also be inappropriate as it exposes patients to other risks and increases costs without providing health benefits.
For the study Wei's team looked at information collected in national databases and identified 71,602 men diagnosed with localized or regional cancer of the prostate between January 2000 and December 2002.
The level of risk to the patients from their cancers was based on how clearly defined the tumor was (well-differentiated), rather than how spread-out it's indistinct boundaries were.
The lower risk group were classified as men of any age with well-differentiated tumors or men 70 years or older with moderately differentiated tumors.
According to the classification approximately a third of subjects (24,825) had a lower cancer risk and were good candidates for a watchful waiting approach, but they underwent immediate treatment, 45 percent received radiation therapy and 10 percent underwent surgical removal of the prostate which equated to overtreatment.
Wei's team says initial expectant management need not be a permanent treatment choice, and some men, in particular younger patients, should eventually proceed to appropriate curative therapy.
They therefore recommend "active surveillance with delayed intervention as an appealing approach to addressing overtreatment concerns among men with lower-risk prostate cancer".