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Islander
12-17-10, 07:16 PM
By Dr. Gabe Mirkin (http://www.healthiertalk.com/users/mirkin) on 12/16/2010

Dear Dr. Mirkin:
Should all prostate cancers be treated?

Answer: Twenty to forty percent of prostate cancers are of such low risk of spreading through the body that they should probably be treated with "active surveillance." In one study, 65-year-old men with low-risk prostate cancer who were given this watchful waiting had 11 years of "quality of life"; many months more than those treated with internal radiation therapy (brachytherapy, radioactive seeds), intensity-modulated radiation therapy (beam radiation), or surgical radical prostatectomy (Journal of the American Medical Association. December 1, 2010).

Prostate cancers that are small, localized to one area, and do not look very malignant under the microscope are called low risk. In the study, these men were treated with "active surveillance": frequent PSA tests, physical exams, and periodic biopsies to monitor the cancer's growth. From previous studies, the authors knew that those who chose immediate treatment reduced their risk of dying from prostate cancer by 17 percent. However, treatment for prostate cancer can cause impotence, incontinence and infections, so the authors devised a "quality of life" scale comparing lengthening of life with adverse side effects. The low risk group who chose watchful waiting had the most quality years.

This recommendation applies only to men with prostate cancer who can live with the fear of not being treated. Watchful waiting is only for men who put a premium on quality of life over the unproved theory that lack of treatment shortens lives. The authors emphasize that, "for some men and their families, the concept that a cancer of any sort is not treated when found early is unthinkable."

http://www.healthiertalk.com/should-all-prostate-cancers-be-treated-2998

Reesacat
12-17-10, 07:41 PM
I think that is a very reasonable approach.

In the six years my late husband underwent treatment for very aggressive prostate cancer we talked with many prostate cancer patients that had undergone surgery, radiation, the radioactive 'pearls', hormone therapy, etc.
Each one of those had side effects that affected the quality of life. Having to deal with urinary incontinence was very frustrating for several who had undergone surgery and radiation.

I do think (using the parameters in this article) waiting is a good option.

Betsy
12-17-10, 09:03 PM
My father was diagnosed with prostate cancer in his mid 80s. They weren't going to bother treating until they found out his father lived to age 105! He's still going at age 90, although other issues are troublesome.

LabDoc
12-18-10, 10:07 AM
Gold Star for Islander. After years of dealing with patients with blood and bone cancers, whichever option is chosen, the bottom line should be 'quality of life'.
We used to have little badges on our white coats "We support Quality of Life Medicine" :) A lot of patients really appreciated it.

Reesacat
12-18-10, 10:18 AM
Gold Star for Islander. After years of dealing with patients with blood and bone cancers, whichever option is chosen, the bottom line should be 'quality of life'.
We used to have little badges on our white coats "We support Quality of Life Medicine" :) A lot of patients really appreciated it.
What a wonderful idea-I know my husband would have loved those badges, as that was what he had dedicated his life to in nursing.

Islander
12-18-10, 10:27 AM
Gold Star for Islander. After years of dealing with patients with blood and bone cancers, whichever option is chosen, the bottom line should be 'quality of life'.
We used to have little badges on our white coats "We support Quality of Life Medicine" :) A lot of patients really appreciated it.

Thanks, but Gold Star goes to Reesacat. She's the one who said it. BTW, I wholeheartedly agree!