Prostate Cancer: Surveillance or Surgery?

November 4, 2009 A SLOW GROWING CANCER: Most of the time, prostate cancer grows slowly. Autopsy studies show many men who died of other diseases also had prostate cancer that never caused a problem. These studies reveal that as many as seven to nine out of 10 men had prostate cancer by age 80 but didn't know it.

WATCHFUL WAITING: Some men may never need treatment for their prostate cancer because it often grows very slowly. In one article, published in the Journal of the National Cancer Institute, researchers estimated that about 25 percent of men diagnosed with prostate cancer will be treated unnecessarily. Some doctors may suggest an approach called "watchful waiting." This has traditionally meant that doctors will "watch and wait" until the cancer causes symptoms before starting any type of treatment. Some men choose this approach to avoid the side effects of strong treatments. Others want a more proactive treatment plan.

ACTIVE SURVEILLANCE: Now, some doctors are employing an approach called "active surveillance." It's slightly more aggressive than watchful waiting. Patients must have a rectal exam and PSA test every four months. They also have a biopsy once a year. Candidates for this plan include patients who have a PSA below 10 and a Gleason score that falls within a specific range. According to the American Cancer Society, not all experts agree on how often testing should occur for active surveillance. There is also a debate about when is the best time to start treatment. Some early studies have shown that men who choose active surveillance and go on to be treated do just as well as those who decide to start treatment right away.

For More Information, Contact:

Lisa Worley
University of Miami Miller School of Medicine
Miami, FL
(305) 243-5184
Lworley2@med.miami.edu

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