This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Contact me when this article is cited  Related Content  • Related articles  • Similar articles in JAMA  Topic Collections  • Men's Health  • Prostate Disease  • Oncology  • Prostate Cancer  • Prognosis/ Outcomes  • Alert me on articles by topic  Social Bookmarking   What's this?

	Since this article does not have an abstract, we have provided the first 136 words of the full text and any section headings.

To the Editor: Dr Johansson and colleagues¹ contribute valuable information on the natural history of prostate cancer. However, in my opinion their conclusions are not warranted. The radical treatments available for this disease involve a significant risk of adverse effects and, consequently, often result in a decreased quality of life for patients. Due to widespread use of prostate-specific antigen testing, overdiagnosis and overtreatment have become significant problems^2-3 in both treatment of indolent tumors and in radical treatment.

After 21 years of follow-up, Johansson et al found no disease progression in 60% of patients and only a 16% disease-specific mortality. These findings should be considered good results. I believe that these results support including a watchful waiting group in treatment protocols and entering patients of any age with well-differentiated and even moderately differentiated tumors into these groups.

Jaime Pujadas Oláno, MD
jaipujadas@hotmail.com
Department of Oncology
Hospital Nostra Senyora de Meritxell (Andorra)
Laboratori de Recerca Translacional
Institut Català d’Oncologia
Barcelona, Spain

1. Johansson J-E, Andrén O, Andersson S-O, et al. Natural history of early, localized prostate cancer. JAMA. 2004;291:2713-2719. FREE FULL TEXT 2. Etzioni R, Penson DF, Legler JM, et al. Overdiagnosis due to prostate-specific antigen screening: lessons from US prostate cancer incidence trends. J Natl Cancer Inst. 2002;94:981-990. FREE FULL TEXT 3. Tannock IF. Eradication of a disease: how we cured symptomless prostate cancer. Lancet. 2002;359:1341-1342. FULL TEXT | WEB OF SCIENCE | PUBMED

Letters Section Editor: Robert M. Golub, MD, Senior Editor.

JAMA. 2004;292:1549.

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

RELATED ARTICLES

Natural History of Early Localized Prostate Cancer
Jonathan R. Osborn and Gerald W. Chodak
JAMA. 2004;292(13):1549.
EXTRACT | FULL TEXT  

Natural History of Early Localized Prostate Cancer—Reply
Jan-Erik Johansson, Ove Andrén, Swen-Olof Andersson, Anders Magnusson, Paul W. Dickman, Lars Holmberg, and Hans-Olov Adami
JAMA. 2004;292(13):1549-1550.
EXTRACT | FULL TEXT  

Natural History of Early, Localized Prostate Cancer
Jan-Erik Johansson, Ove Andrén, Swen-Olof Andersson, Paul W. Dickman, Lars Holmberg, Anders Magnuson, and Hans-Olov Adami
JAMA. 2004;291(22):2713-2719.
ABSTRACT | FULL TEXT