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Prostate Cancer: The Case For Watchful Waiting

Prostate cancer is one of the leading cancer causes of death in men in the US.  The American Cancer Society estimates that approximately 1 in 7 men will be diagnosed with prostate cancer in his lifetime.  But, while this is a widespread condition, and treatment is sometimes warranted, the medical industry has begun to see a shift in the prostate cancer treatment, choosing to actively monitor patients over time instead of choosing to perform surgery or conduct radiation immediately.  This treatment path is called “watchful waiting”, and is becoming more and more common for men with prostate cancer.

To understand why watchful waiting is becoming a more popular trend, let’s back up a bit and explain a little more about the diagnosis of prostate cancer.  The average age of men diagnosed with prostate cancer is 66 years old.  Common treatment options for prostate cancer have included medication, surgery to remove the prostate, chemotherapy, radiation, and even hormone therapy.  And while these treatments have become more and more effective over the years, they cause unwanted side effects (such as incontinence and impotence) and pose serious risks (like blood clots in the legs and lungs, heart attack, pneumonia, and infections.)

There has been much debate around whether or not the benefits of treatment outweigh the added side effects and risks that are introduced when one undergoes these types of therapies.  Additionally, it is not clear if these treatment options will completely eliminate the cancer.  For those patients who are low risk, the benefit of aggressive treatment compared to the potential side effects may just not be worth it.

What types of patients may be good candidates for watchful waiting?  Those who are not seeing any symptoms from the cancer, those whose cancer is small, and located only in the prostate, and those whose cancer is expected to grow slowly all may benefit from this type of treatment.

Additionally, older men who have a life expectancy of less than 10 years may not benefit from the added years that surgery can offer, making them a better candidate for watchful waiting.

However, if the cancer is growing steadily, or spreading beyond the prostate, more aggressive treatment is usually recommended.  Men who are diagnosed young may also benefit from more aggressive treatment, as there is a greater chance that the cancer may grow worse over a longer span of time.

Whatever stage you are at, only you and your doctor can decide what is best for you.  Be sure to talk with him or her about the risks and benefits associated with each treatment path prior to making a final decision.

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