Should Warren Buffett’s cancer get treated?

at 04:59 PM ET, 04/18/2012


(RICK WILKING - REUTERS)
When Warren Buffett’s doctor recently administered a test for prostate cancer — a test that came back positive — he went against long-established medical guidelines. He also, perhaps unknowingly, leapt into a fierce policy debate about unnecessary care.

The U.S. Preventive Task Force says that men over 75 shouldn’t have regular tests, as there’s little benefit to early detection. That’s because prostate cancer is incredibly slow growing; even if caught early, there’s a high chance that it will never cause medical harm. “Early diagnosis,” the Wall Street Journal’s Ron Wilson contends, “can lead to over-detection and over-treatment of disease that will never cause any problems.”

Doctors are split as to whether, in elderly men, to treat prostate cancer with radiation (which has its own health risks) or use an approach dubbed “watchful waiting,” where they keep an eye out for negative developments. Some tell NPR they’re worried about Buffett’s decision to move forward with the treatment option:

Buffett’s letter says his prostate cancer is Stage 1, or localized. His doctors told him the cancer isn’t “remotely life-threatening,” according to the letter. Generally speaking, [urologic cancer specialist Benjamin] Davies says, Stage 1 means “the chances of dying of the disease in next 10 years is less than 1 percent.”
For men Buffett’s age, “a substantial number ... may not need treatment” for a detected prostate cancer, Peter Carroll, chief of urology at University of California, San Francisco, told The Wall Street Journal Health Blog. Their doctors can watch tumors and intervene later, if needed. Most prostate cancers grow slowly.
Still, it’s possible that Buffett’s test results suggested a more aggressive cancer. When it comes to prostate cancer in men of all ages, Davies says, “The problem is that we don’t quickly treat the right people, and we overtreat most people.”
He says Buffett’s case may come to represent the past way of doing things. In the future, Davies says, doctors won’t be treating 81-year-olds for prostate cancer. There’s going to be less treatment period, he says, after new types of tests allow doctors to figure out who needs treatment early and who can be left alone.

As Wilson cautions, “People who swear by Buffett’s investment strategy may want to think carefully before following his course on prostate care.”

 
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