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A new medical study suggests a way to help men with early, low-risk prostate cancer avoid being overtreated for a disease that in most cases will never threaten their lives. It found that a drug can slow the growth of these tumors in men who opt to be monitored instead of having treatment right away.
This is the first time that a drug for treating enlarged prostates also has been shown to help treat prostate cancer in a rigorous study. It may persuade more men to choose active surveillance, or "watchful waiting," instead of rushing to have treatments that can leave them with urinary or sexual problems, doctors say.
"We're identifying men who are not likely to need even a pill," said Dr. Maha Hussain, a University of Michigan cancer specialist. But Americans fear cancer so much that they want some kind of treatment and underestimate the financial and medical risks of treating low-risk cases, she added.
She is program chair of a cancer conference in Florida where the study will be presented later this week. Results were released Tuesday in a telephone news conference sponsored by the American Society for Clinical Oncology.
Roughly half of the 218,000 men diagnosed each year in the United States with prostate cancer have low-risk disease -- PSA blood levels under 10 and low tumor aggressiveness scores.
"The American view of cancer" is that it's always best to treat, so about 80 percent of these men choose to have that right away, said Dr. Otis Brawley, a prostate cancer expert who is chief medical officer of the American Cancer Society.
In Europe, though, most choose watchful waiting -- close monitoring and treatment only if the cancer progresses or causes pain or other problems.
Doctors know that drugs that shrink the prostate -- GlaxoSmithKline PLC's Avodart and Merck & Co.'s Proscar -- can help prevent prostate cancer. But federal health advisers recently recommended against taking them for this purpose because of potential risks.
The new study tested Avodart "not to prevent cancer, but to prevent the progression" of it in men who already have the disease, which may be a much better use of such drugs, said the study's leader, Dr. Neil Fleshner of University Health Network and Princess Margaret Hospital in Toronto.
"We know the vast majority of these men are not destined to die from that cancer," and wanted to see if Avodart could make "watchful waiting" safer, Fleshner said.
The study enrolled about 300 men in the United States and Canada with low-risk cancer that was confirmed by a biopsy.
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