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The Daily Wildcat

 

Cancer Center doctor agrees some cases can go untreated

Mike Christy / Arizona Daily Wildcat

Chief Cancer Control Officer M. Peter Lance, M.D., in his office in the Arizona Cancer Center Wednesday on North Campbell Avenue.
Mike Christy
Mike Christy / Arizona Daily Wildcat Chief Cancer Control Officer M. Peter Lance, M.D., in his office in the Arizona Cancer Center Wednesday on North Campbell Avenue.

Prostate cancer patients may be receiving unnecessary treatment for tumors that would have never progressed, a recent study conducted by John Hopkins University reports.

The study gave cancer patients with small tumors the option of prostate removal or “”active surveillance,”” in which doctors monitored tumor growth without resorting to surgery. The study found that of the men who chose active surveillance, only 20 to 30 percent of their tumors progressed.

Screening tests for prostate cancer detect not only potenitally lethal but also benign tumors that would cause no problem if undetected, as stated in the article entitled “”Rethinking Screening for Breast Cancer and Prostate Cancer,”” published in The Journal of the American Medical Association.

The Prostate Specific Antigen test, the method for testing prostate cancer, is responsible for many cases of unnecessary cancer treatment, said Dr. Peter Lance of the Arizona Cancer Center.

“”A lot of prostate cancer gets diagnosed on the basis of having an apparently abnormal PSA. A lot of the prostate cancers that get diagnosed in that way are never destined to progress to something that is going to threaten the life of that man. What has been happening is that a lot of men have been getting aggressive, usually surgical, treatment on the basis of PSA tests and therefore they’ve been getting over treated,”” Lance said.

The use of active surveillance instead of surgery is not a new idea, Lance said.

“”There’s nothing new or particularly original about the John Hopkins study. This is a discussion that’s been going on for a number of years. There is an approach called Watchful Waiting,”” he said.

Though this has long been an option, Lance says that many men still opt for surgery.

“”There are other men who have an abnormal PSA test and get a prostate biopsy which suggests that they may have some cancer in their prostate glands, and they decide to get rid of that cancer even though that cancer perhaps isn’t going to do them any harm. So, they undergo surgery because they don’t like the idea of any cancer being left in their body,”” he said.   

Unnecessary surgeries may be a product of Prostate Specific Antigen testing, but this should not discourage men from being screened, Lance said.

“”It’s not appropriate to come out and say that men should not get a PSA test, but what is happening is that the whole approach to screening for prostate cancer is under review and it’s clear that previous claims about the benefits of PSA testing have been exaggerated,”” he said.

As early screenings for certain types of cancers become more common, researchers have found that for prostate cancer, many of the early cancers go nowhere, a recent article in the New York Times said.

Screenings may lead to overtreatment in prostate cancer patients, but these findings cannot be applied to all cancers, Lance said.

“”I think that the message that needs to get out is that different cancers behave in very different ways, so what I’ve just described for prostate cancer does not necessarily apply to breast cancer or colon cancer or uterine cancer or pancreas cancer,”” he said.

Dr. Lance stressed that even if the tumors found are not lifethreatening, screening and early detection are key to cancer treatment.

“”Despite what the (New York Times) article says, depending on the type of cancer, in general the earlier you can diagnose and treat cancer, the better the prognosis,”” he said.

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