This post is on the same theme that I blogged on some months ago. Last week’s NEJM had a sobering article on the side effects of treatment for prostate cancer. A picture is worth a thousand words, so here is the one on urinary issues:
And here is the one on sexual function:
This study reflects the outcome among 1655 men with early prostate cancer, 1164 of whom were treated with surgery and 491 of whom received radiotherapy. ~60% of these men had Gleason scores of 2-4 and it could be argued did not need any treatment for their cancer at all. The scoring has migrated over time, so we can assume that they would now mostly be in the Gleason 6 category. ~70% had PSA scores <10.
So it brings us back to the old question: If we find low grade cancer, should it be treated….and even more perplexing, should we have found it in the first place if we aren’t going to treat it anyway? Please see my thoughts on screening elsewhere in this blog. Have a nice week. I will be at the ASCO GU meeting next week.