For older prostate cancer patients with a short life expectancy, aggressive treatments often do more harm than good, Yale School of Medicine researchers say.
Yale scientists analyzed nine years of Medicare data and found a trend toward higher use of curative treatment for prostate cancer among men with certain types of tumors and a short life expectancy. The study included 39,270 patients ages 67 and older.

The results suggest that cancer treatment was increasingly aggressive in patients who had the lowest likelihood of seeing clinical benefits, said lead researcher Dr. Cary Gross, an associate professor of internal medicine at Yale. Gross said such aggressive treatment puts patients at risk for complications and increases costs without medical benefits.
"We found that the percentage of men who received treatment for their prostate cancer treatments increased over time from 61.2 percent to 67.6 percent from 1998 through 2007," said Gross. "However, we were surprised to find that the biggest increase was among men with moderate-risk prostate cancer who had the shortest life expectancy. On the other hand, cancer treatment decreased among men with low-risk tumors and longer life expectancy."

The National Comprehensive Cancer Network recommends actively monitoring patients – a practice known as “watchful waiting” -- as an alternative to medication for those with less aggressive tumor types and shorter life expectancies.

"Future work should explore how better to incorporate both cancer characteristics and patient life expectancy into decision making," said Gross.