American Society for Radiology Oncology (ASTRO) President Anthony Zietman, MD, of Massachusetts General Hospital and Harvard University in Boston, said that radiation treatment should be employed as opposed to the watchful waiting method, as doctors currently have little way to tell if prostate cancer will progress or remain somewhat asymptomatic. Zietman made the comments while addressing the Medicare Evidence Development and Coverage Advisory Committee (MEDCAC) this week during a meeting about radiation therapy for treatment of localized prostate cancer.
The meeting, which focused on the risks, benefits and outcomes of radiation therapy treatments for localized prostate cancer sought to hear comments regarding treatment options to provide recommendations to the Centers for Medicare & Medicaid Services (CMS) for what should be covered by Medicare and Medicaid, based on scientific evidence.
In speaking to the treatment options for prostate cancer weighed against watchful waiting, Zietman offered clinical data regarding successful radiation therapy techniques, including external beam radiation therapy and brachytherapy, and how these options are treating men with prostate cancer without significant side effects.
Acknowledging that while it is possible that some men receiving treatments for the disease may have done well without treatment through watchful waiting or active surveillance, Zietman said: “Primary treatment for localized prostate cancer saves lives,” noting that this data is supported by multiple clinical studies.
In addition, radiotherapy also prolongs survival after initial surgery for prostate cancer, he said.
In his discussion of stereotactic body radiation therapy as a treatment option, Zietman noted that prospective, phase 2 studies have shown intrinsic, short-term safety and efficacy of this method, but additional studies are required to further prove survival and quality of life measures.
Zietmen noted that his conclusions are applicable to the Medicare population because the median age of the participants from the recent trials is 65, “thus potential Medicare enrollees are enormously represented,” he said.
"Prostate cancer is the number one cancer diagnosed in men,” said Zietmen. “I applaud MEDCAC for studying this important issue and appreciate the opportunity to participate in the forum.”