PRESS-NEWS.org - Press Release Distribution
PRESS RELEASES DISTRIBUTION

Long-term risks from prostate cancer treatment detailed in new report

Report says those considering PSA screening need such quantitative information on risks and benefits of treatment if they are to make truly informed decisions, yet leading guidelines do not provide specific estimates of risk.

2024-11-07
(Press-News.org)

The risks of adverse effects and complications from treatment for prostate cancer are substantial and continue for years after treatment ends. The largest comprehensive analysis reporting long-term risks from such treatment relative to the risks faced by a control group of untreated men has just been published in the journal JAMA Oncology.

In the 12 years following treatment, men whose initial treatment was a prostatectomy (removal of all or part of the prostate) had a risk of urinary or sexual complications more than seven times higher than that faced by untreated men. For men whose first treatment was radiotherapy, the risk of such complications that was almost three times that of untreated men. Additionally, men in the radiotherapy group faced three times the risk of a bladder cancer diagnosis.

The report – by researchers from the SWOG Cancer Research Network, a clinical trials group funded by the National Cancer Institute (NCI), part of the National Institutes of Health (NIH), along with researchers from the NCI – argues that men need to have access to risk numbers such as these when deciding whether to even be screened for prostate cancer.

“This study throws down a major gauntlet to all physicians to give patients this information before they even begin the process of drawing a PSA test,” said the paper’s senior author Ian M. Thompson, Jr., MD, of CHRISTUS Santa Rosa Health System and The University of Texas Health Science Center at San Antonio. A PSA test measures the blood level of a protein called prostate-specific antigen.

Roughly 30 million men in the U.S. are in the age range (55-69 years) for which the U.S. Preventive Services Task Force recommends discussing PSA testing with their doctor. Making an informed decision requires that they have a clear understanding of the magnitude of the potential risks and benefits of screening, and of each step that might follow it, which can include a biopsy and one or more treatments if prostate cancer is found.

One challenge in determining the risk of adverse effects from prostate cancer treatment is that for some of these conditions, such as erectile dysfunction, the incidence increases with age. So, a true measure of risk can be determined only by comparing men treated for prostate cancer with untreated men of similar age in the general population. The JAMA Oncology study does just that.

“Past studies of prostate cancer treatment complications have had small sample sizes, limited follow up, or the absence of a valid control group,” said lead author Joseph Unger, PhD. “Our study is distinguished by long follow-up, out to 12 years, looking at a broad spectrum of key complications. Critically, we were able to compare treated men to a representative control group of untreated men, which prior studies have not included.”

The issue of comparing to a valid control group is key, Dr. Unger noted: “Without this, it is difficult to understand the true magnitude of treatment complications.”

Dr. Unger is a biostatistician and health services researcher with SWOG Statistics and Data Management Center and associate professor at Fred Hutch Cancer Center.

The researchers studied almost 52,000 men who had enrolled to one of two large NCI prevention studies – the Prostate Cancer Prevention Study (PCPT) and the Selenium and Vitamin E Cancer Prevention Trial (SELECT). 

To track participants’ diagnoses and treatment, they linked trial data to Medicare claims data, identifying 29,196 participants who had Medicare claims available and met other eligibility criteria. Among these, 3,946 had been diagnosed with prostate cancer, including 655 whose first treatment for the disease was a prostatectomy and 1,056 whose first treatment was radiotherapy.

Participants who had been diagnosed with prostate cancer but had not received treatment (because this cancer tends to grow slowly, many men choose active surveillance), along with those who had not been diagnosed with prostate cancer, served as an untreated control group for comparison.

For both groups, the research team examined the Medicare claims data for instances of 10 potential treatment-related complications and adverse effects: urethral stricture, placement of an artificial urinary sphincter (for severe incontinence), placement of a penile prosthesis, urinary incontinence, erectile dysfunction, radiation cystitis, radiation proctitis, bladder cancer, bladder cancer followed by cystectomy, and rectal cancer.

Those in the prostatectomy group had a 12-year risk of having at least one of these 10 complications that was more than six times (6.57) greater than the risk faced by untreated participants.

For men in the radiotherapy group, their 12-year risk of experiencing at least one of the 10 complications was 3.04 times greater than it was for those who had not been treated.

Moreover, after 12 years, those in the radiotherapy group were almost three times (2.78) as likely as untreated participants to have been diagnosed with bladder cancer, which is often of higher grade in those who previously had radiotherapy.

The authors argue that given the uncertain benefit of prostate cancer treatment for most patients, these findings highlight the importance of patient counseling before treatment and before screening. 

They specifically recommend that quantitative information on the risks and benefits of prostate cancer treatment be included in national cancer screening and treatment guidelines. No national organization currently provides such quantitative information in their guidelines. 

This research was supported in part by the NIH/NCI through grants CA189974, CA182883, and legacy grant CA37429 and in part by The Hope Foundation for Cancer Research.

In addition to Drs. Unger and Thompson, co-authors on the study included Cathee Till, MS, and Catherine M. Tangen, DrPH, both of SWOG Statistics and Data Management Center and Fred Hutch Cancer Center; Dawn L. Hershman, MD, of Columbia University Medical Center; Phyllis J. Goodman, MS, Michael LeBlanc, PhD, William E. Barlow, PhD, and Riha Vaidya, PhD, all of SWOG Statistics and Data Management Center and Fred Hutch Cancer Center; and Lori M. Minasian, MD, and Howard L. Parnes, MD, both of Division of Cancer Prevention, U.S. National Cancer Institute.

SWOG Cancer Research Network is part of the National Cancer Institute's National Clinical Trials Network and the NCI Community Oncology Research Program and is part of the oldest and largest publicly funded cancer research network in the nation. SWOG has 20,000 members in 45 states and eight other countries who design and conduct clinical trials to improve the lives of people with cancer. SWOG trials have directly led to the approval of 14 cancer drugs, changed more than 100 standards of cancer care, and saved more than 3 million years of human life. Learn more at swog.org, and follow us on Twitter (X) at @SWOG.
 

Reference:
Unger, et al. “Long-Term Adverse Effects and Complications After Prostate Cancer Treatment.” JAMA Oncol. Published online November 7, 2024. doi:10.1001/jamaoncol.2024.4397

END



ELSE PRESS RELEASES FROM THIS DATE:

Does more virtual care mean more low-value care? Study suggests no

Does more virtual care mean more low-value care? Study suggests no
2024-11-07
Before 2024 ends, Congress will decide whether to keep or change rules about telehealth, or let them expire. And even though the decision will focus on Medicare’s payment for virtual patient care, it will likely impact telehealth access for people with other kinds of health insurance too. Now, a new University of Michigan study suggests that policymakers can rest easier about one of the top worries about telehealth: that virtual care will drive up the use of tests and scans that patients don’t need, wasting money and resources. In fact, the study shows that low-value care didn’t rise faster at primary care practices that used telehealth the most, compared with those ...

City of Hope Research Spotlight, October 2024

City of Hope Research Spotlight, October 2024
2024-11-07
City of Hope® Research Spotlight offers a glimpse at groundbreaking scientific and clinical discoveries advancing lifesaving cures for patients with cancer, diabetes and other chronic, life-threatening diseases. Each spotlight features research-related news such as recognitions, collaborations and the latest research defining the future of medical treatment. This roundup highlights the biology behind our sense of smell, real-world data that can be used to refine esophageal cancer treatment guidelines, a potential new approach to treating patients with type 2 diabetes, a new way to target pancreatic cancer ...

Increased focus on comorbidities, socioeconomic factors would help improve health equity for people with COPD

2024-11-07
Miami (November 7, 2024) – Health care providers treating people with COPD also need to focus on the person’s socioeconomic factors, along with considering their additional health conditions or comorbidities, according to a new article. The article is published in the September 2024 issue of Chronic Obstructive Pulmonary Diseases: Journal of the COPD Foundation, a peer-reviewed, open-access journal. Chronic obstructive pulmonary disease (COPD) is an inflammatory lung disease, comprising several conditions, including chronic bronchitis and emphysema, and can be caused by genetics ...

Gut dysbiosis and fecal microbiota transplantation in pancreatic cancer: Current status and perspectives

Gut dysbiosis and fecal microbiota transplantation in pancreatic cancer: Current status and perspectives
2024-11-07
Pancreatic ductal adenocarcinoma (PDAC) is recognized as one of the most lethal cancers, with an estimated five-year survival rate of approximately 10%. This poor prognosis is largely attributed to the challenges in early diagnosis, aggressive tumor biology, and limited treatment options. Most PDAC cases are diagnosed at advanced stages due to its typically asymptomatic onset, making only a small percentage of patients eligible for potentially curative surgical resection. In recent years, increasing attention has been paid to the role of gut microbiota dysbiosis in PDAC, as ...

Prevalence of unrecognized cognitive impairment in socially and economically vulnerable older adults is high

2024-11-07
INDIANAPOLIS – One of the first studies to investigate the prevalence of unrecognized cognitive impairment among patients seen at Federally Qualified Health Centers, has found that it is ubiquitous, especially among minoritized older adults. These facilities provide primary care and preventive services regardless of ability to pay or health insurance status to more than 30 million patients, including a growing number of older adults. Early and equitable detection of cognitive impairment can benefit patients and their families. Delaying diagnosis leads to poor health outcomes for patients ...

Men who have sex with men in Europe still vulnerable to hepatitis A and B, highlighting need for public health action and support

Men who have sex with men in Europe still vulnerable to hepatitis A and B, highlighting need for public health action and support
2024-11-07
Research analysing European survey data from 113,884 men who have sex with men (MSM) and published in Eurosurveillance indicates that while most MSM have a basic understanding of viral hepatitis, only 44% report having been vaccinated against both hepatitis A and B.  The data highlight notable immunisation gaps despite available vaccination and recommendations. Strong public health support and creating an open environment that enables MSM to follow recommendations will be crucial to reduce outbreaks among MSM and eliminate hepatitis B. Men who have sex with men are more likely to get infected with ...

Cancer genetic risk assessment guidelines expand to meet growing understanding of hereditary risk

Cancer genetic risk assessment guidelines expand to meet growing understanding of hereditary risk
2024-11-07
PLYMOUTH MEETING, PA [November 7, 2024] — The National Comprehensive Cancer Network® (NCCN®)—an alliance of leading cancer centers focusing on maintaining evidence-based expert consensus driven guidelines for care—announces the publication of the expanded NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Genetic/Familial High-Risk Assessment: Breast, Ovarian, Pancreatic, and Prostate. This closely follows the recent publication of the expanded NCCN Guidelines® for Genetic/Familial High-Risk Assessment: Colorectal, Endometrial, and Gastric.  Additional cancer types were added to the title and content for both guidelines. ...

Advances in screening and early diagnosis of pancreatic cancer

Advances in screening and early diagnosis of pancreatic cancer
2024-11-07
Pancreatic cancer (PC) presents substantial diagnostic challenges due to its aggressive nature and lack of early symptoms, leading to late detection and poor prognosis. According to recent cancer statistics, PC ranks as the fourth leading cause of cancer deaths globally, with increasing incidence, particularly in high-risk regions such as China. Factors such as a shortage of specific and reliable screening markers, along with a lower prevalence in the general population, make effective large-scale screening a formidable tasko assess advancements in diagnostic techniques, artificial intelligence integration, biomarker discoveries, ...

Metabolic dysregulation and metabolite imbalances in acute-on-chronic liver failure: Impact on immune status

Metabolic dysregulation and metabolite imbalances in acute-on-chronic liver failure: Impact on immune status
2024-11-07
Acute-on-chronic liver failure (ACLF) is a life-threatening condition characterized by acute deterioration of liver function in patients with pre-existing chronic liver disease. It is often accompanied by multiorgan failure and systemic inflammation, with high short-term mortality rates. The triggers for ACLF include bacterial infections, acute alcoholic hepatitis, and ischemic hepatitis, leading to the release of pro-inflammatory mediators. These systemic inflammatory responses result in immune dysfunction, contributing to the progression of the disease​. Recent research has emphasized the metabolic changes ...

Elite coaches see compassion as a path to better performance

2024-11-07
It may sound like a contradiction to talk about compassion in the competitive world of elite sport. After all, isn't elite sport all about becoming hardened to resistance and adversity? But this is a false dichotomy, according to a new study that analysed the views of 12 Danish high-performance coaches on the use of compassion in their work with elite athletes. In fact, there is a broad consensus among the coaches, most of whom are head of national teams, about the benefits of using compassion, says the study's lead author, Emilia Backman from the Department of Psychology, University of Copenhagen. "All of the high-performance ...

LAST 30 PRESS RELEASES:

Unlocking predictors of success in treating inflammatory bowel disease (IBD)

New PFAS removal process aims to stamp out pollution ahead of semiconductor industry growth

Researchers identify reduction in heart failure-related risk factors following metabolic surgery

The Kenneth H. Cooper Institute at Texas Tech University Health Sciences Center unveiled in Dallas

DNA evidence rewrites story of people buried in Pompeii eruption

DNA evidence rewrites histories for people buried in volcanic eruption in ancient Pompeii

People with schizophrenia show distinct brain activity when faced with conflicting information

Climate change: Significant increase in carbon dioxide emissions from private aviation

Planting trees in the Arctic could make global warming worse, not better, say scientists

Finding function for noncoding RNAs using a new kind of CRISPR

Neurodevelopment in the first 2 years of life following prenatal exposure to maternal SARS-CoV-2 Infection

Racial disparities in genetic detection rates for inherited retinal diseases

Stem cells shed insight into cardiovascular disease processes 

New study: Plastics pollution worsen the impacts of all Planetary Boundaries

Long-term risks from prostate cancer treatment detailed in new report

Does more virtual care mean more low-value care? Study suggests no

City of Hope Research Spotlight, October 2024

Increased focus on comorbidities, socioeconomic factors would help improve health equity for people with COPD

Gut dysbiosis and fecal microbiota transplantation in pancreatic cancer: Current status and perspectives

Prevalence of unrecognized cognitive impairment in socially and economically vulnerable older adults is high

Men who have sex with men in Europe still vulnerable to hepatitis A and B, highlighting need for public health action and support

Cancer genetic risk assessment guidelines expand to meet growing understanding of hereditary risk

Advances in screening and early diagnosis of pancreatic cancer

Metabolic dysregulation and metabolite imbalances in acute-on-chronic liver failure: Impact on immune status

Elite coaches see compassion as a path to better performance

Microplastics impact cloud formation, likely affecting weather and climate

ECOG-ACRIN and PrECOG announce multiple presentations at ASH 2024

Off-the-shelf thermoelectric generators can upgrade CO2 into chemicals. The combination could help us colonize Mars

What makes human culture unique?

Researchers discover dozens of new genes associated with disc herniations

[Press-News.org] Long-term risks from prostate cancer treatment detailed in new report
Report says those considering PSA screening need such quantitative information on risks and benefits of treatment if they are to make truly informed decisions, yet leading guidelines do not provide specific estimates of risk.