A growing number of older U.S. men with prostate cancer are receiving treatments that carry a risk of side effects that can significantly reduce quality of life without prolonging life, according to a Cedars-Sinai study released Monday.

These men may not have life expectancies that would allow them to see the benefits of more aggressive treatments, the researchers said.

The findings were published in the peer-reviewed journal JAMA Internal Medicine and can be read at: jamanetwork.com/journals/jamainternalmedicine/article-abstract/2825764.

Prostate cancer is the second most common cancer in the United States, surpassed only by breast cancer. About one-eighth of U.S. men are diagnosed with prostate cancer at an average age of 67, according to the National Cancer Institute.

Most patients have slow-growing, localized tumors confined to the prostate gland that are unlikely to be life-threatening. Instead of emergency treatment, these low-risk patients can be monitored through “active surveillance,” where examinations and tests are performed at regular intervals to ensure the disease is not progressing.

“Conservative management,” which includes active surveillance or watchful waiting, is also recommended for men with limited life expectancy who will not live long enough to benefit from aggressive local treatment, even for high-risk cancers.

But for these men, the trend is in the opposite direction, according to researchers’ analysis of comprehensive data from the U.S. Veterans Affairs health care system. They found that among men with limited life expectancies and intermediate- and high-risk cancers, fewer received conservative treatment and more received aggressive local treatment with surgery or radiation.

Director of Urologic Oncology Research at Cedars-Sinai Department of Urology and corresponding author of the study, Dr. “We found this pattern surprising,” said Timothy Daskivich.

“Prostate cancer patients with a life expectancy of less than five or 10 years were undergoing treatments that could last up to ten years to significantly increase their chances of surviving cancer, despite guidelines advising against the treatment.”

The study analyzed medical data on 243,928 men diagnosed with localized prostate cancer in the Veterans Affairs healthcare system between 2000 and 2019. Among patients with an average life expectancy of less than 10 years, the proportion who received treatments such as surgery or radiation for a low duration—rather than active surveillance—reduced the risk of prostate cancer from 37.4% to 14.7%; however, the rate of intermediate-risk disease treatment increased from 37.6% to 59.8%.