Seeking New Options for Prostate Cancer

Article preview from Medtech Insight - August, 2010

Recent reports questioning the benefits of early prostate cancer diagnosis and treatment have raised an industry-wide debate that has been fueled by the limitations of prostate-specific antigen tests, currently the standard of care for early prostate cancer detection. While the industry searches to improve the use of PSA tests, urologists are asking, "are we over treating our patients?" That question was repeatedly voiced in a number of forums at the American Urological Association's 2010 Annual Meeting. As for a definitive answer to the question, it is a somewhat difficult task to get individual physicians to admit they are personally over treating patients; however, there is definitely a consensus-and a concern-that more patients than necessary are receiving treatments that put them at risk of serious side effects.

Seeking New Options for Prostate Cancer

by Robert Neil

Although modern medical technology has given physicians an impressive number of tools to address serious medical conditions, urologists who treat prostate cancer are struggling with an issue on the other extreme: overtreatment. Over the years, a large amount of money and effort has been invested into research aimed at improving outcomes for men with prostate cancer, the second most commonly diagnosed cancer (following skin cancer) among men in the US. However, recent reports questioning the benefits of early prostate cancer diagnosis and treatment have raised an industry-wide debate that has moved beyond medical journals and into the mainstream media.

The discussions have been fueled by the limitations of prostate-specific antigen (PSA) tests, currently the standard of care for early prostate cancer detection. While the industry searches to improve the use of PSA tests, urologists are asking, "are we over treating our patients?"

That question was repeatedly voiced in a number of forums at the American Urological Association's (AUA) 2010 Annual Meeting, held in San Francisco this spring. As for a definitive answer to the question, it is a somewhat difficult task to get individual physicians to admit they are personally over treating patients; however, there is definitely a consensus—and a concern—that more patients than necessary are receiving treatments that put them at risk of serious side effects.

It is estimated one in six men will be diagnosed with prostate cancer in their lifetimes, and one in 36 will die from the disease. Age is a man's biggest enemy—as far as risks are concerned—because incidence rates for the condition continually rise until around 70 years of age. ( See Exhibit 1.) From 2002 to 2006, men aged 70 to 74 years had the highest incidence rate with 888.6 cases per 100,000 white men and 1,279.1 cases per 100,000 African-American men.

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