A New View on Prostate Cancer
Treating elderly men right after diagnosis is better than the current ‘watchful waiting’ approach, a study indicates.
By Thomas H. Maugh II, Times Staff Writer
Los Angeles Times
February 26 2006

It is better to treat prostate cancer in the elderly early on rather than to wait and watch for signs of progression, as is now commonly done, according to a new study that may change the care for many patients with the deadly disorder.

Surgery or radiation therapy in elderly men increases survival by at least 30%, raising median survival times from 10 years to more than 13 years, researchers reported Saturday at a prostate symposium in San Francisco.

The finding in a study of about 49,000 men “challenges long-held beliefs about prostate cancer treatment” by suggesting that treatment is better than so-called watchful waiting, said Dr. Paul Lange of the University of Washington, who did not participate in the study.

“It’s a wonderful paper that validates what many of us have believed for a long time,” said Dr. Mark Kawachi, director of the prostate cancer center at City of Hope National Medical Center in Duarte.

“Age, in and of itself, is not a definitive determinant of whether you should be excluded from treatment” for prostate cancer, he said.
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New research at Wake Forest University Baptist Medical Center shows that Positron Emission Tomography (PET) is more accurate than conventional imaging in identifying patients who have good responses to chemotherapy and radiation treatment – a finding that could one day help some patients avoid surgery.

The results, from a study of 64 patients with esophageal cancer, are published in the April issue of Annals of Surgery. PET, a technology that produces images of the metabolic function of tissue, was used to test patients for cancer after treatment with a combination of chemotherapy and radiation (chemoradiation).

“While additional multi-center studies are needed, the research clearly shows that PET is a useful tool for identifying patients who respond well to chemoradiation,” said Edward A. Levine, M.D., lead investigator. “Being able to identify these responders may alter the need to take some patients to surgery.”
(full story…)

Lung cancer patients should not be denied surgery based on their age, concluded UAB researchers Robert J. Cerfolio, M.D., and Ayesha S. Bryant, M.D., in a study of 726 patients with non-small cell lung cancer.

Researchers compared morbidity, mortality and long-term survival rates among different age groups, including patients younger than age 70, those between 70 and 74, 75 and 79, and 80 and older.

They found no significant difference in hospital length of stay, major morbidity or death rates during surgery between the elderly groups and the younger control groups. “Short-term risks and long-term survival are similar to younger patients,” Bryant said. The award winning study was presented at the 2006 Society of Thoracic Surgeons’ meeting in Chicago.