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DO ALL PROSTATE TUMORS NEED TREATMENT?

A new study of hundreds of men with prostate cancer supports the idea that those over age 65 with slow-growing tumors may live as long without treatment as with it.

It is the first such study done solely among American men, and its findings parallel previous U.S. and international data, researchers said in Wednesday's issue of The Journal of the American Medical Association.Prostate cancer is the second leading cancer killer of men, after lung cancer.

Elderly men with slow-growing prostate cancers, which amount to 10 percent to 15 percent of all prostate cancers diagnosed, died no sooner than men their age in the general population, the researchers found.

Elderly men with moderately fast-growing prostate cancers died four to five years sooner than elderly men in the general population, and those with fast-growing malignancies died six to eight years earlier, researchers said.

The findings neither support nor oppose surgery and radiation to treat prostate cancer among the elderly, said the study's lead author, Dr. Peter C. Albertsen, chief of urology at the University of Connecticut Health Center in Farmington. Nor do the findings apply to younger men.

Previous research suggested that elderly men with slow-growing tumors may live as long with no treatment as they would if their cancers were removed or irradiated.

That is because for men over 65, problems such as heart disease or other cancers become increasingly likely to kill them before prostate cancer does. And the potential drawbacks of treating prostate cancer can be great, including impotence and urinary incontinence.

The study involved 451 men ages 65 to 75 who were listed in Connecticut's tumor registry as having been diagnosed between 1971 and 1976 with prostate cancer that had not spread. Researchers followed the men for 15 years.

Dr. Patrick Walsh, director of the Brady Urological Institute at Johns Hopkins Hospital in Baltimore, said that doing without treatment is appropriate in only a small percentage of cases.