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January 2017

Avoiding Undertreatment of Aggressive Prostate Cancer by Early Use of Chemotherapy

Author Affiliations
  • 1Division of Oncology, Department of Medicine, University of Washington School of Medicine, Seattle
  • 2Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
  • 3Department of Urology, University of Washington School of Medicine, Seattle
JAMA Oncol. 2017;3(1):13-14. doi:10.1001/jamaoncol.2016.3634

Should chemotherapy be used in nonmetastatic prostate cancer?—Yes

The controversy surrounding overdiagnosis and overtreatment of prostate cancer (PC) has received substantial attention with the US Preventive Services Task Force (USPSTF) recommendations on prostate-specific antigen (PSA) screening.1 Although the majority of men with PC die with the disease rather than as a result of the disease,2 the natural history is quite heterogeneous. In addition, the incidence and prevalence of men with PC is high, and more than 26 000 men succumb to the disease annually in the United States.2 Therefore, selection of patients appropriate for aggressive intervention is important, not only to avoid overtreatment but also to ameliorate undertreatment.

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