Prostate Cancer Radiation May Harm Older Patients

About 240,000 American men will develop prostate cancer in 2013, and 29,720 patients will die from the disease according to the U.S. National Cancer Institute. New study suggests that radiation therapy has become the norm for prostate cancer in the U.S.

However, surgery, radioactive seed implants, and radiation can do more harm than good for elderly patients according to a new study. Older men will not live long enough to benefit from the treatment because the treatment can cause serious side effects such as bowel problems, urinary incontinence, and erectile dysfunction.  Older patients aged 61 to 74 with slower growing prostate cancer that has at least three other problems like hypertension, diabetes, arthritis, and congestive heart failures  are 40% more likely to die of something other than cancer during 10 years after diagnosis.  Therefore, they should carefully consider their options, whether they should undergo aggressive treatments.

“If you’re going to die of a heart attack in five years, what’s the point of going through radiation?” asked Dr. David Penson, the study’s senior author from the Vanderbilt University Medical Center in Nashville, Tennessee. “The key point is that when men are choosing therapy for prostate cancer, they need to consider their tumor characteristics, their age and other characteristics,” he said.

IMRT for prostate cancer

According to American Cancer Society, one in every six men will be diagnosed with prostate cancer. Many patients choose radiation and surgery even though it can lead to serious side-effects, but some doctors recommend active surveillance as an alternative.

More than 1,000 American men who had radiation therapy after prostate cancer surgery,  the newer form called intensity-modulated radiotherapy (IMRT), had no greater advantage over the conventional version. The long-term side effects are not lower either.

IMRT accounted for 96% of all external radiation treatments in 2008. The latest radiation technique, proton beam therapy, is twice as expensive, but it is supposed to be even more targeted than IMRT but according to research, newer technology is no better.

Medicare payments can reach up to $40,000 per patient, depending on the state.

Xofigo Approved By FDA

FDA was scheduled to decide on Xofigo by August 14th, 2013 for symptomatic late-stage castration-resistant prostate cancer.  The medication was reviewed under the FDA’s priority program which is a speedier process to provide safe and effective treatment when no alternative therapy is available.

Xofigo was designed for male patients whose prostate cancer has metastasized despite surgical and medical intervention to reduce the levels of testosterone, a hormone that stimulates growth and spread of the disease.

Almost 90% of metastatic prostate cancer patients have reached the bones which make the patients more susceptible to skeletal events, the main cause of morbidity and death.

Xofigo may cause nausea, vomiting, swelling of a foot, leg or ankle, and diarrhea, although some patients may develop lymphocytopenia, anemia, neutropenia, and leucopenia.

Prostate cancer new screening guidelines

Millions of men aged 40 to 54 who are at average risk for prostate cancer are being told not to undergo routine screening according to the new guidelines of the American Urological Association. Saint Louis University Hospital urologist, Sameer Saddiqui thinks that they have been over-diagnosing prostate cancer in the U.S. They want to be more targeted to those who will truly benefit from the screening like African-Americans and those with strong family history of the disease.

Written by: Janet Grace Ortigas

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