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When people hear a diagnosis of cancer, they naturally worry about the future. The first thought is often to do something to try to rid the body of the abnormal cells. But many men with prostate cancer are increasingly being told to watch and wait rather than undergo aggressive surgery or radiation therapy. The majority of prostate tumors are slow-growing and rarely cause death. A recent study in the Journal of Clinical Oncology followed more than 12,000 men with prostate cancer. Although all had their prostates removed, they were still at risk for cancer recurrence, especially if they had aggressive tumors.
These patients were followed for 15 years. Surprisingly, after that time only 12 percent had died of cancer, whereas nearly 40 percent had died from some other cause. The lead investigators concluded that the likelihood of dying from prostate cancer is surprisingly small, especially for low-grade, slow-growing tumors. An active surveillance program may be more appropriate and less likely to result in side effects such as impotence or incontinence. When given the entire story, many men can live with prostate cancer without feelings of anxiety or depression.
[Journal of Clinical Oncology, July 27, 2009 and Cancer, September 1, 2009]
http://jco.ascopubs.org.libproxy.lib.unc.edu/cgi/content/abstract/JCO.2008.18.2501v1
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Every time I hear this view about prostate cancer, I think of my father, who was told the same thing - he'd probably die of something else first. But it didn't work that way. He'd still be alive if he had treated it early. He was in excellent health otherwise. My husband had prostate cancer, treated it right away, and has completely recovered. Why gamble?
I agree, I have a friend who decided to watch and wait, and now it's in his lymph nodes.
The secret is knowing if it's low grade or not, he didn't know until too late.
The treatment called HIFU which is in use anywhere except the USA has such a low side-effect rate that it's worth doing no matter what, as if the doctor didn't get all the cancer the patient can always have surgery or radiation done later. We use HIFU in the USA if radiation fails, so why not use it first? Published incontinence rate with HIFU is 1 in 172, ED is 20%, no recovery time needed.
My husband had it done last year and doesn't worry about cancer returning, as the gland was cooked and that caused necrosis, ash came out through a supra pubic catheter, and it was gone. If cancer returns it's because the cancer was outside the gland.
I'm not following the logic. "Wait and Watch," yet none of the 12,000 men waited. They all had surgery.
PEOPLE'S PHARMACY RESPONSE: THE STUDY WAS BASED ON RECURRENCE RATES--A LATE OUTCOME.
The side effect that my husband had from his radiation treatments was radiation proctitis. In other words, the radiation burned a hole in his rectum. He bled to death four and a half months after finishing his radiation. At the conclusion of the radiation he waited six weeks for his urology checkup and the doctor said he was fine. This was a rather small, contained tumor to begin with and his PSA afterward was down to 2.3. If he had known that his side effect would be death, he would have chosen watchful waiting!
My husband is recovering from robotic prostatectomy.... returned to work just six weeks after surgery. He had minimal side effects from this procedure. We are both glad he had it done, as there's no more worrying about it.