Men debate best way to test, treat prostate cancer

Recommendations from the federal government recently sparked a debate among men about how best to test for and treat prostate cancer. Two new studies in the New England Journal offer some answers.

The experimental drug enzalutamide can help men with advanced prostate cancer live longer and have a higher quality of life, one study found. The drug works by blocking testosterone from stimulating prostate cancer cells.

"There was a four-, five-month increase in life in the men who got this drug versus the men who did not," said Dr. Erik Goluboff, a urologist at Beth Israel Medical Center in New York.

The drug was so successful that the treatment was offered to all the study participants.

A second study found that measuring the PSA levels in men between the ages of 55 and 69 could lead to fewer deaths from prostate cancer. Treating the cancer too early and too aggressively, however, can have a negative impact on the quality of a patient's life.

"This gain in years lived is discounted by the fact that many of these men had complications from their treatment," including erectile dysfunction and incontinence, Goluboff said.

A federal task force has recommended against giving the PSA test, which measures a protein to determine the likelihood of prostate cancer. The task force said that saying that routine screening often leads to unnecessary and harmful tests and treatment.

Eduardo Cruz, 64, decided to hold off treating his early prostate cancer for that reason. He said he trusts his doctor to help him weigh the risks and benefits and make the best decision. 

"The doctor is just waiting to see if the cancer grows or becomes more aggressive. Then we'll treat it," Cruz said.