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Watchful waiting, the prostate cancer treatment dilemmaWhether 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 or active surveillance. 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: means that cancer starts grow and needs treatment. What are the benefits of watchful waiting?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: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.Active surveillance is particularly useful for men with low-risk prostate cancer who are more elderly. It is not generally recommended for younger men with this disease below the age of 60 because they have potentially longer life spans when the cancer can become a problem. 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 newsResearchers of Memorial Sloan-Kettering Cancer Center, New York, report in the April issue of The Journal of Urology that carefully selected men with "low-risk" prostate cancer can safely delay treatment and opt instead for active surveillance. [ read full article ] In 2005, the Scandinavian Prostate Cancer Group Study 4 (SPCG-4) reported that radical prostatectomy improved prostate cancer survival compared with watchful waiting after a median of 8.2 years of follow-up. [ read full article ] A multi-center study of prostate cancer patients appearing in today's Journal of Urology recommends that for some men diagnosed with low-risk prostate cancer, opting not to initially receive treatment can be safe if they are closely monitored. [ read full article ] 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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