Prostate cancer and overtreatment: check life expectancy

Prostate Specific Antigen

The generalised use of the PSA test for prostate cancer treatment has led to earlier diagnosis of the condition. This development is an advance in itself, since the early stages are less serious and thus easier to cure. But not all prostate cancers are equally aggressive; like many diagnostic tests, the administration of PSA detects tumours more easily, including those that grow at a slower rate. Consequently, a considerable number of tumours diagnosed from a PSA test develop very slowly, thus exposing patients to the risks of over-diagnosis or over-treatment(over-treatment can be associated with undesirable side effects such as impotence or incontinence).

In the absence of markers that make it possible to identify tumours that are specifically aggressive, the main difficulty with prostate cancer diagnosis lies in assessing the benefits for the subject, taking account of the risks of over-diagnosis and over-treatment (which can vary between 30% and 50% according to the literature). It is therefore necessary to compare theoretical life expectancy, and thus to assess such cancers correctly. In practice, if the patient’s life expectancy exceeds 10 years, a period considered necessary for a cancer that has become clinically significant, the treatment is justified.
Source: Cancer Epidemiology
2013/11/28