Breakthrough study may change the future of prostate cancer treatment

As I started reporting last summer, coronavirus panic caused many patients to put off seeking much-needed medical care. It also caused an almost-complete shutdown of routine cancer screenings for several months. As a result, we’re now witnessing a surge in the discovery of real, aggressive cancers of all kinds.  

However, on the upside, there was also a short-lived lull in the problem of cancer overdiagnosis and overtreatment. (Remember, many routine screenings such as mammograms lead to the overtreatment of small lesions of “questionable” cells. But if left completely alone, these growths would not have caused any harm to the patient.)  

The shutdown also allowed us the unprecedented opportunity to examine which kinds of medical care are actually needed and useful...and which do not really make a difference.  

For example, a brandnew study published in JAMA Oncology looked at the effect of delays in radiation treatment on mortality rates in men diagnosed with prostate cancer. 

And here’s what researchers found… 

Do delays in treatment impact survival rates? 

The new study involved more than 63,000 men diagnosed with intermediate-risk, high-risk, or very high-risk prostate cancerThe researchers divided the men into four groups—depending on when they started radiation therapy: 

  • The first group started radiation therapy within zero to 60 days before initiating hormone therapy. 
  • The second group started it within zero to 60 days after initiating hormone therapy. 
  • The third group started it within 61 to 120 days after initiating hormone therapy. 
  • The fourth group started it 121 to 180 days after initiating hormone therapy. 

As it turns out, there was no difference whatsoever in mortality rates among the four groups. In fact, even men with high-risk (but non-metastatic) prostate cancer who delayed radiation treatment did not experience higher mortality rates.   

This finding is key. Because as I’ve often reported, mortality rate is the one statistic we can trust. Especially when it comes to cancer. It’s the ultimate litmus test for whether a treatment or intervention works. 

Interestingly, the researchers applauded this finding. In fact, the study co-author, Dr. Vinayak Muralidhar, M.D., stated, “The findings are reassuring to patients and allow us to come up with a flexible radiation schedule for prostate cancer that ensures their safety. The results have important implications for patients in areas experiencing a surge in COVID-19 cases who can opt to wait for a safer time to come in and initiate treatment. 

But hold on…is that really how we should objectively interpret these findings? 

If the timing of treatments doesn’t make one iota of difference in mortality rates…even among those with “high-risk” prostate cancer…perhaps the treatment itself doesn’t matter!?  

In fact, in my view, these findings suggest that we should rethink the whole approach to treating most types of prostate cancer. And, as other studies suggest, perhaps “watchful waiting” is the best approach…even for men with so-called “aggressive” cancer. 

Furthermoreperhaps the classification of “highrisk” prostate cancer isnt really accurate at all. Indeed, lots of recent research suggests that we should also question the way pathologists and urologists assign risk to men with prostate cancer. 

You can learn everythingyou need to know about prostate cancer prevention and treatment in the June 2018 issue of my monthly Insiders’ Cures newsletter (“The big fat reason why so much prostate cancer research is flawed”). Not yet a subscriber? Click here to become one today! 


“Relative Timing of Radiotherapy and Androgen Deprivation for Prostate Cancer and Implications for Treatment During the COVID-19 Pandemic.” JAMA Oncol. 2020;6(10):1630-1632.