Wednesday, April 27, 2005

Rabbit Season

If you use a shotgun to keep rabbits out of your vegetable garden, you'll probably take care of the rabbit problem if you don't mind riddling your vegetables with buckshot. Sound absurd? It is. But it's even more absurd when a shotgun solution is applied to health problems. Radiation treatment is a common form of prostate cancer therapy. But those who undergo external-beam radiation may be creating more health problems than they solve. In the April 2005 issue of the journal Gastroenterology, researchers from the University of Minnesota (UM) report on a study examining the secondary effects of external-beam radiation for localized prostate cancer. The UM team used data from the medical records of more than 85,000 men with prostate cancer who participated in the SEER (Surveillance, Epidemiology and End Results) Program, an ongoing data collection project maintained by the National Cancer Institute. About 30,500 of the men received radiation treatment between 1973 and 1994. When researchers compared the rates of subsequent colorectal cancer cases to the two groups (men who received radiation and men who did not), risk of developing colorectal cancer was 70 percent higher for men in the radiation group. The UM researchers noted that although today's radiology methods are more advanced than they were in 1994, parts of the rectum are still exposed when external beam radiation is used. Their recommendation: When prostate cancer is treated with radiation, patients should be closely monitored for colorectal cancer. In previous alerts I've noted these two key prostate cancer facts: 1) Most prostate cancer patients are diagnosed after the age of 60, and 2) In most cases, prostate cancer grows so slowly that men who develop the cancer are more likely to die of other causes. That second point is confirmed by a new study that appeared in the January 2005 issue of the Journal of Clinical Oncology. Two researchers at the German Center for Research on Aging used the SEER database to assess the five- and 10-year survival rates for more than 183,000 men with prostate cancer. They found that 99 percent of the men survived for at least five years, and 95 percent survived for at least 10 years. Furthermore, when these rates were compared to all-cause-mortality in men of the same age in the general population, the survival rates were nearly the same. So treatment is a dilemma. Should radiation be used, increasing the risk of colorectal cancer? Should the prostate be removed, increasing the risk of incontinence and impotence? These questions can only be answered on a case-by-case basis, but it underlines the importance of proceeding with caution or getting a second opinion when a doctor recommends a therapy that may have dire consequences. As the University of Minnesota researchers noted in their study, prostate cancer is common and survivorship is likely, so understanding the long-term effects of any treatment is particularly important.

15 Comments:

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