Medicine: Treatment of early prostate cancer.

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News from the World of Medicine
  • 2017 08 Medicine, Treatment of early prostate cancer
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It looks like that screening for prostate cancer does not lead to an advantage. I must admit that not all specialists agree, that this topic is discussed controversially, but most professors most probably would agree with me that the advantage of screening for prostate cancer has not been demonstrated. The data are not convincing.
Most cancer types have four stages: Stage I, Stage II, Stage III, and Stage IV. When professors speak of “early cancer,” they mean—not always, but in most instances—Stage I, Stage II, Stage IIIA and Stage IIIB. And when they speak of “late cancer” or “advanced cancer,” they mean Stage IIIC and Stage IV. Also, prostate cancer can be summarised as localised prostate cancer, and high-risk Stage III and Stage IV. The treatment of localised prostate cancer is in large parts different than the treatment of prostate cancer high-risk Stage III or Stage IV.
The clinical study “ProtecT” included 1643 men with localised prostate cancer. The men were randomised to three groups: Upfront surgery, upfront radiotherapy, and no treatment (only observation). All groups had ten years of follow-up. The clinical result was identical in all three groups: The mortality is identical in all three groups. And the cancer-specific mortality is identical in all three groups. Only in the secondary advantages and disadvantages, there were some differences. After this study, a new clinical study was published, and once again the same result: In men with localised prostate cancer: There is no significant difference between the options treatment and no treatment (only observation), both in how long these men live, respectively, whether they die because of their cancer.
If you are going to screening for prostate cancer, but you have made up your mind already today that you would choose the option no treatment (only observation), should one day localised prostate cancer be diagnosed, then it makes no sense for you personally to go to screening for prostate cancer.

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