In a nutshell
This review evaluated the impact of delayed treatment among patients with prostate cancer.
Some background
Prostate cancer refers to the uncontrolled growth and division of prostate cells. In some cases, this uncontrolled growth proceeds very slowly and may take years to develop into a life threatening condition. These cancers are termed low-risk. Since cancer treatments are not without risk or side effects, close observation rather than immediate treatment is often recommended for low-risk patients. This treatment strategy is known as active surveillance. However, delaying treatment also entails the risk of undetected cancer progression and as a result reduced overall survival.
Methods & findings
This review analyzed 17 studies, including a total of 34,517 patients diagnosed with prostate cancer. Time until beginning of treatment was analyzed to determine its affect on cancer outcomes.
Seven of the reviewed studies found no significant impact on the outcome of low-risk patients with treatment delay. Two of these studies included only men with low-risk prostate cancer while the other five included both low and intermediate risk cancer patients.
Four studies found that treatment delay significantly affects cancer outcomes such as time to disease progression and urinary complications. Two of these studies included only low-risk patients. These studies concluded that delayed treatment resulted in worse outcomes once treatment was eventually started, but overall survival did not seem to be affected. The other two studies included intermediate and high-risk patients as well as low-risk patients. One study concluded that for intermediate-risk patients, a significant unfavorable effect is associated with a treatment delay of more than 9 months. Another study concluded that for non-low-risk patients, cancer outcomes are affected when treatment is delayed by more than 2.5 months.
The bottom line
This review concluded that for low-risk patients, delaying treatment does not seem to significantly affect cancer outcomes. Delayed treatment does seem to be associated with worse treatment outcomes among non-low-risk patients.
What’s next?
Consult with your physician regarding the risks and benefits of delayed cancer treatments.
Published By :
European Urology
Date :
Aug 01, 2013
