Naslund said there was a small subset of older patients with early cancer whom he would treat hormonally: those whose cancer cells are highly aggressive and on the verge of spreading. Doctors can identify such patients by observing the shape of their tumor cells under a microscope. Well under 5 percent of elderly patients with localized prostate cancer are in this category, he said.
Indeed, the Robert Wood Johnson study found that survival from prostate cancer was slightly higher among such men who were treated hormonally - but overall, survival was about the same. The men died at the same rate, just less often from prostate cancer.
According to Walsh, there's a simple explanation. Studies have shown that the treatment itself kills a significant number of older men. "It's the cardiovascular disease and the worsening of diabetes," Walsh said.
