watchful waiting



Watchful waiting, the prostate cancer treatment dilemma

Whether to treat prostate cancer is one of the biggest dilemmas for today patients, especially those who are feeling healthy yet.

It is a fact that prostatectomy or other prostate cancer treatment turns man's world upside down. All studies show roughly that about one half of patients become impotent right afterward surgery or 2 years of having radiation therapy. Many men are left with lack of urination control (incontinence).

What means watchful waiting?

It is known that many prostate cancers are not aggressive, they are small and grow slowly. A man with a slow-growing tumor has almost the same life expectancy as a man who doesn't even have prostate cancer. Any man having prostate cancer growing slowly still can enjoy his masculinity.

Why to treat it, then?

Some doctors instead recommend watchful waiting. Within watchful waiting, prostate cancer gets no treatment, but patient must see the doctor often for regular digital rectal examinations, PSA tests or needle biopsies every 6-12 months. The watchful waiting means to monitor signs of the prostate cancer. If there's no evidence the cancer is growing, patient continues to get no treatment. Only if signs worsen, such as:

  • prostate cancer is found in a greater number of biopsies or
  • primary Gleason grade 4 or 5 is found upon repeat biopsy or
  • PSA doubling time is les than 3 or
  • PSA velocity is greather than 0.75
    means that cancer starts grow and needs treatment.

    What are the benefits of watchful waiting?

  • Avoid possible side effects of therapy that may be unnecessary
  • Quality of life retained
  • Patients can enjoy normal activity

    What are the risks and disavantages of watchful waiting?

    Watchful waiting doesn't mean the man is completely healthy. Therefore, the main risk is the possibility to ignore the medical monitoring of disease and to miss the opportunity for right cure. We can also list the followings:

  • Risk of cancer progression
  • Subsequent treatment may be more aggressive with increased side effects
  • Frequent exams and screenings are required
  • Anxiety caused by uncertain history and term of prostate cancer

    Is watchful waiting the best option every time?

    Many studies suggest that about half of newly diagnosed prostate cancer patients are eligible for active surveillance. The truth is watchful waiting is up to patients choice, especially if they are young or feel that the side effects of treatment outweigh the benefits. At the same time, older men with early-stage prostate cancer are not taking a big risk if they keep an eye on the disease for a while instead of treating it right away.

    One after another, the new opinion is that watchful waiting prostate cancer should be the first option, unless there are strong evidence that tumor is very aggressive.

    Latest news

  • Prostate cancer: When to wait and when to treat
    Researchers at Fred Hutchinson Cancer Research Center have a lead role in a new public/private partnership to create the first systematic surveillance program of men with prostate cancer to look for biological clues to help determine when to wait and when to treat the disease. [ read full article ]



    [ read more articles ]



    NOTE: Issues on this site regarding men's health and their concerns, are provided for information only, and are not meant to substitute for the advice of your own physician or other medical professional. Prostate-Report.org does not endorse any specific product, service or treatment.





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