80% of Prostate Cancer Operations are Unnecessary
Prostate cancer kills 10,000 men per year in the UK1, and 27,000 in the USA2. In men aged 85 and over, prostate cancer overtakes lung cancer to become the most common cause of cancer deaths.
It is therefore important that it is diagnosed and treated early, to ensure the best chance of survival. What is not well known is that most cancers of the prostate are not life-threatening, and a leading doctor has suggested that only 1 in 6 operations carried out for Prostate Cancer removes a growth which would lead the sufferer to an early death. The other 80%+ are 'clinically insignificant cancers, which would never develop into fatal prostate cancer'3
The first indication that a patient may have Prostate Cancer is often, especially in the USA where testing is most common, be through a PSA test which measures the level of Prostate Specific Antigen in the blood. The conformation is to take a sample of tissue from the Prostate for examination under a microscope. This process, common to many diagnostic procedures, is call a 'biopsy'.
Elevated levels of PSA have traditionally been seen as a potential sign of prostate cancer. But the researchers found that parathyroid hormone, a substance the body produces to regulate calcium in the blood, can elevate PSA levels in healthy men who do not have prostate cancer. These “non-cancer” elevations in PSA cause many men to be given a biopsy unnecessarily, which often leads to unnecessary treatment.
“PSA picks up any prostate activity, not just cancer,” said lead investigator Gary G. Schwartz, Ph.D., M.P.H., an associate professor of cancer biology and epidemiology and prevention at the Wake Forest University School of Medicine. “Inflammation and other factors can elevate PSA levels. If the levels are elevated, the man is usually sent for a biopsy. The problem is that, as men age, they often develop microscopic cancers in the prostate that are clinically insignificant. If it weren’t for the biopsy, these clinically insignificant cancers, which would never develop into fatal prostate cancer, would never be seen.”
However, because PSA screening has become so common, more men are test positive and go on to have a biopsy. Most men, unsurprisingly, elect to have treatment when told that they have prostate cancer. In reality, Schwartz said, in only one of six cases does a biopsy diagnosis of prostate cancer result in a cancer that would be fatal if untreated.
High rates of prostate biopsy, therefore, lead to the over treatment of prostate cancer, he said, leading to an increased rate of the side effects of treatment, including impotence and urinary incontinence. Other reported common side-effects of treatment include penile shrinkage and gynecomastia (swollen breasts in men).
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