Cancer treatment that keeps on giving trouble

We've discussed before the dangers of routinely screening for prostate cancer, a test that too often leads to unnecessary treatments with damaging consequences. Earlier this year, in fact, the U.S. Preventive Services Task Force (USPSTF) formally advised against routine prostate cancer screening. Now, the findings of a new study bolster that recommendation, suggesting that treatments for prostate cancer result in side effects that linger for a decade, or more.

The study, led by a cancer specialist at the Lombardi Comprehensive Cancer Center at Georgetown University, involved a comparison of over 500 men who had been screened for prostate cancer. About half the men had prostate cancer detected and treated, while the other men remained cancer-free. Treatments included surgery, hormonal therapy, and/or radiation. After taking into account the men's age, overall health, and other factors, the researchers found that over 95 percent of the treatment group had worse sexual and urinary function even 10 years later. The findings, published in the Journal of Clinical Oncology, echo those reported in earlier studies. Yet no prior research had followed men for quite so long after treatment.

Thus these new findings underscore the lasting side effects of treatment and of treatment that is, in most cases, unnecessary. Several studies have found no evidence that the PSA blood test used to screen for prostate cancer actually saves lives. "These are very serious statistics," notes Dr. Whelan. "Unfortunately, the risks attendant upon prostate screening have been downplayed for too long."

And as Dr. Ross points out, "We know now that most cases of prostate cancer should be treated with active surveillance. It's a small percentage of cancers that actually develop into something that requires treatment. If doctors are forthright when discussing the ramifications of both prostate cancer and its treatment, the number of men whose lives were needlessly ruined by complications of treatment would surely go down.