Both too much and too little treatment of prostate cancer

By Eivor Hernes, medical doctor and researcher at the Cancer Registry of Norway, Norwegian Radium Hospital and Vestre Viken Hospital Trust (Buskerud County)

Translation: Barbara Mortensen

More and more men are diagnosed with prostate cancer and the question if treatment is given according to national guidelines is highly relevant. Until recently we have not had enough data to answer this question. However, a newly published article in the British Journal of Urology- International shows that data from the Cancer Registry of Norway and the Prostate Cancer Registry may give us the answer.

The Prostate Cancer Registry is a quality registry for incidence, diagnostics and treatment of prostate cancer in Norway. It is localized in the Cancer Registry and started registration in January 2004. By using data from the Cancer Registry and the quality registry, it is possible to identify patients who can be candidates for curative treatment and afterwards examine if they actually got this treatment.

The newly published article indicates that nearly one third of these patients with localized or intermediary or aggressive illness did not get curative local treatment, which in other words means too little treatment. Among these patients 18 were dead due to prostate cancer by the end of the survey.

On the other hand, 57 per cent of the patients with localized and low risk illness were given curative local treatment; a treatment that can lead to grave side effects. This treatment could perhaps have been delayed or for some avoided, with today’s knowledge; in other words some were perhaps treated too much.

To improve health authorities handling of patients with prostate cancer, it is important that results such as these come forward. In other words, that one continues to support national registries like the Prostate Cancer Registry.