Men with three comorbidities should forgo PCa Tx

May 20, 2013

Older prostate cancer patients with three or more underlying health conditions should think twice before committing to surgery or radiation therapy for their cancer, according to a multicenter study led by UCLA urologists.

Older prostate cancer patients with three or more underlying health conditions should think twice before committing to surgery or radiation therapy for their cancer, according to a multicenter study led by UCLA urologists.

The study reports the 14-year survival outcomes of 3,000 men diagnosed with prostate cancer between 1994 and 1995. Results suggest that older patients with low- to intermediate-risk prostate cancer and who have at least three comorbidities were much more likely to die of non-prostate cancer causes, said study first author Timothy Daskivich, MD.

“For men with low- to intermediate-risk disease, prostate cancer is an indolent disease that doesn’t pose a major risk to survival,” Dr. Daskivich said. “The take-home point from this study is that older men with multiple underlying health problems should carefully consider whether they should treat these tumors aggressively, because that treatment comes with a price.”

The study was published May 21 in the early online issue of Annals of Internal Medicine.

Men in the study completed surveys within 6 months of diagnosis to document what other medical conditions they had at that time. Researchers then determined survival outcomes at 14 years from the time of diagnosis using information from the Surveillance, Epidemiology and End Results database.

The study looked at older patients with three or more comorbidities, such as diabetes, hypertension, congestive heart failure, and arthritis. Researchers found that the 10-year risks of dying from causes other than prostate cancer in men 61 to 74 years and men older than 75 with three or more comorbidities were 40% and 71%, respectively. In comparison, the 14-year risks of dying from low- or intermediate-risk prostate cancer were 3% and 7%, respectively.

By contrast, older men with high-risk, aggressive prostate cancers may benefit from treatment. The risk of death from high-risk prostate cancer was 18% over the 14 years of this study.

The study was funded by the Robert Wood Johnson/VA Clinical Scholars Program, Urology Care Foundation of the AUA, American Cancer Society, and National Institutes of Health.

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