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Prostate Cancer Treatment Can Wait for Some
Men with localized prostate cancer need not rush into making treatment decisions. A recent study found no survival difference after 15 years among 1,600 men with localized prostate cancer in the U.K. who were randomly assigned to one of three treatment approaches: surgery, radiation or active monitoring of the cancer. The study found 15-year survival was high—97%—for all three groups. Lead study author Freddie Hamdy, a urological surgeon at the University of Oxford in England, said the results show men shouldn’t panic or hurry to get treatment for prostate cancer. Instead, he said in an article in STAT, they should “consider carefully the possible benefits and harms caused by the treatment options.” Among the serious side effects of surgery and radiation used to treat prostate cancer are sexual dysfunction and incontinence. The study results don’t apply to men with high-risk or more advanced prostate cancer, who do require urgent treatment, said Hamdy. Despite the similarity in survival numbers among the three groups after 15 years, the study revealed differences in the rate of prostate cancer spread. For men in the active-monitoring group, 9.4% experienced cancer spread. The surgery group had a 4.7% spread rate, while the radiation group experienced a 5% spread rate. But cancer spread doesn’t predict prostate cancer death, said Hamdy, adding, “This is a new and interesting finding, useful for men when they make decisions about treatments.”
Women, Sex and Cancer
The number of studies examining the effects of cancer and cancer treatments on women’s sex lives has grown in recent years, but the increase in research has had little impact on women’s experiences in the clinic, according to an article in the New York Times. Chemotherapy can cause vaginal dryness and atrophy, as well as mouth sores, nausea and fatigue. Surgeries like hysterectomy and mastectomy can remove women’s sensations of sexual arousal and orgasm. And pelvic radiation therapy can lead to shortening and narrowing of the vagina. One study found that 66% of women with cancer experienced sexual dysfunction, while another study found that nearly 45% of young female cancer survivors weren’t interested in sex for more than a year after their diagnosis. Yet despite the growing body of research on the topic, study results along with anecdotal evidence indicate that not much has changed in medical practice. “They don’t tell you going into it that you are going to experience dryness. They don’t tell you that you are going to experience lack of desire,” said Cynthia Johnson, a 39-year-old breast cancer survivor. And research shows gender discrepancies in who gets asked about cancer. A 2020 survey of 391 cancer survivors revealed that 53% of male cancer patients were asked about their sexual health, while only 22% of female patients were asked.
First Inflation Penalties Set to Lower Costs for Medicare Recipients
The U.S. government will subject 27 drugs to “inflation penalties,” to reduce out-of-pocket costs for Medicare recipients, President Joe Biden announced March 15. In the last quarter, drug manufacturers raised the price of 27 drugs higher than the inflation rate and will need to pay the difference for those medicines to Medicare in the form of a rebate, according to a report in Reuters. The step is being taken under a provision of the Inflation Reduction Act passed in 2022. Medicare will start reducing out-of-pocket costs for patients in April, and the government will update the list of drugs each quarter. The current list of 27 drugs includes cancer medicines such as Padcev (enfortumab vedotin) and Yescarta (axicabtagene ciloleucel). “It’s going to change the way drugs are priced, lower the costs for seniors long term,” Biden said in a speech in Las Vegas.
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