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JNCI Journal of the National Cancer Institute 2002 94(6):407-409; doi:10.1093/jnci/94.6.407
© 2002 by Oxford University Press
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Journal of the National Cancer Institute, Vol. 94, No. 6, 407-409, March 20, 2002
© 2002 Oxford University Press

EDITORIAL

Androgen Deprivation as Primary Treatment for Early Prostate Cancer: Should We "Just Do Something"?

James A. Talcott

Correspondence to: James A. Talcott, M.D., Center for Outcomes Research, Massachusetts General Hospital, B75 230, 55 Fruit St., Boston, MA 02114–2696 (e-mail: jtalcott@partners.org).

In few diseases are treatment options as distinct, consequences as enduring, and the supporting data as uncertain as for early prostate cancer. The abrupt general acceptance of prostate-specific antigen (PSA) screening a decade ago doubled the number of men diagnosed annually (1,2) and brought the average age at diagnosis forward an estimated 5 years (so-called lead time) (3). The increased incidence, earlier diagnosis, and prostate cancer's usually indolent natural history, further magnified by another effect of screening—length-biased sampling— resulted in an estimated 1.4 million U.S. prostate cancer survivors in 1998 (Surveillance, Epidemiology, and End Results [SEER1] Program data: http://cancercontrol.cancer.gov/ocs/prevalence). Five-year survival rates for all prostate cancer patients rose from 80% in 1986 to 97% in 1993, the most recent patients' cohort with 5-year SEER data. Yet no randomized trial comparing any of the primary treatment modalities for early (nonmetastatic) prostate cancer—radical . . . [Full Text of this Article]

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V. B. Shahinian, Y.-F. Kuo, J. L. Freeman, and J. S. Goodwin
Determinants of androgen deprivation therapy use for prostate cancer: role of the urologist.
J Natl Cancer Inst, June 21, 2006; 98(12): 839 - 845.
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