Treatments for prostate cancer are often worse than the disease itself

“Too many men are being treated for prostate cancer.”

That’s the frightening finding of a study just published in JAMA — and the words of its lead researcher, Dr. Karim Chamie, a urology professor at the University of California.

But even worse…

The majority of those men are being hustled into immediately starting toxic radiation treatments for no valid reason.

And what’s behind all this unnecessary radiation? Well, that might even be more disturbing.

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The prostate treatment myth
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When Dr. Herbert Lepor, chair of the department of urology at NYU Langone Medical Center, said that “The majority of prostate cancers…are not significant,” and “they would be best not diagnosed,” many doctors were shocked.

Certainly, everything we’ve heard about cancer says that early treatment saves lives.

But this new research gives more credence to that advice than ever before.

Because the treatment a man with prostate cancer gets can end up killing him long before the disease ever would.

And even scarier, it doesn’t depend on age, how aggressive a cancer is, or even any other medical condition.

It’s all about the specialist you’re referred to — and whatever treatment brings in the most money.

The patient, and his condition “contribute very little to the decision-making process,” Dr. Chamie said.

This study looked at 38,000 men over 65 who were diagnosed with prostate cancer over a three-year period. Dr. Chamie set out to discover why more men don’t use a wait-and-watch approach before starting any treatment (something he, and many other experts, regard as a much better option).

And what he found was that only 10 percent of those men didn’t immediately have surgery or radiation.

The majority, nearly 60 percent, started right up with radiation therapy. And remember, that “choice” had almost nothing to do with how advanced (or not) their cancer was.

Once a patient is seen by a radiation specialist, the odds are “extremely high” they are going to get radiation, Dr. Chamie said.

He also noted that radiation brings in more money to doctors than surgery. And that’s something he believes also plays a role in the decision.

Of course this money-driven decision making starts long before the diagnosis. It starts with that other “cash cow,” the PSA test.

Even the conservative United States Preventive Services Task Force did an about-face recently.

The group no longer advises men of any age to have routine screenings for prostate cancer, as it leads to “considerable overdiagnosis.” And it noted that the “harm” of treatments (like radiation) don’t “outweigh the benefits.”

The group also said that most of the cancers detected by PSA screenings would never have caused problems for the patient in the first place.

But surgery and radiation, on the other hand, are a different story.

These “treatments” can cause incontinence, impotence, bowel dysfunction, and even death.

Dr. Chamie’s approach to slow-growing prostate cancer is “active surveillance,” something he said that’s commonly practiced at UCLA.

And some recent research from Harvard suggests that may also be the best method not only for men with “low risk” cancers, but even more advanced ones.

So before you let your doctor fast-track you into receiving surgery or radiation to treat prostate cancer – or even having a biopsy done after a PSA test – the best course of action may be to stop, take a deep breath, and get another opinion.

Sources:

“Too many prostate cancer patients being treated?” Randy Dotinga, February 19, 2015, Web MD, webmd.com

“Radiation used in too many men with indolent prostate cancer” Pam Harrison, February 23, 2015, Medscape, medscape.com