Cancer Surgery Errors
Thousands of men could be spared radical surgery if they were monitored for signs of increased prostate cancer risk rather than rushed into treatment, scientists said today.
The Institute of Cancer Research said that men’s health was being put at risk because the current test for prostate cancer – the PSA test – was inadequate.
The scientists said the test was unable to distinguish between cancers which were “tigers” and those which were “pussycats”, leading many into treatments they did not need.
Removing the prostate, radiotherapy and hormone treatment can leave men with serious long-term side-effects such as incontinence and impotence.
Professor Colin Cooper, head of the Everyman Male Cancer Research Centre at the institute, said surgery could be avoided in as many as half of men with positive PSA tests. Instead he advocated a system of “active surveillance” where men with slightly raised PSA levels could be monitored for further increases which would warrant treatment. But in many cases he said men could live with cancer with no harmful effects to their health.
The Failure of PSA
“Firstly, it doesn’t detect all cancers, and secondly, when it does detect cancer, it cannot predict how that cancer will behave,” Prof Cooper said. “This often results in men being given invasive treatment that they do not require. What we urgently need is a test which can differentiate between cancers that are aggressive, the tigers, and those that are pussycats, but meanwhile PSA is the best we’ve got.”
Dr Chris Parker, from the institute, added: “Prostate cancer is the only human cancer that is curable but which commonly des not need to be cured.
“It can often be so slow growing as to never cause the patient any ill effects. So it can be a case of the cure being worse than the disease. The challenge is to identify who needs to be treated and who doesn’t.”