The Prostate Puzzle
When to Operate
By NESITA KWAN
Updated 5:16 AM CST, Tue, Mar 17, 2009
It's a life or death decision for more than 200,000 men each year. That's how many men are diagnosed with prostate cancer a year in the U.S. It's also how many men make the tough decision for either surgery, or "watchful waiting."
Until now, that decision's often been a crap shoot. There are no standards for which treatment is best, especially when the cancer is in it's earlier stages. Prostate cancer usually is so slow growing that If the patients decide to wait, up to half will die of other causes, not prostate cancer. On the other hand, other patients are having surgeries they don't need.
"Some men may be rushing into treatment that won't necessarily benefit them, prevent problems, or prolong life," said University of Chicago study author Dr. Scott Eggener. "Close observation in certain patients may provide and maintain quality of life without increasing the chances of the cancer spreading."
So for many men, watchful waiting is the way to go. In his study, Dr. Eggener first diagnosed the prostate tumor based on standard blood and biopsy results. But then he added a second biopsy six months later, and more biopsies every one to two years. That gave him the information he needed to predict which cancers needed surgery, and which did not.
"It identifies men unlikely to be affected by their cancer and encourage frequent monitoring and then starting therapy at a later appropriate time if needed. Cure rates appear to be identical when these men choose immediate treatment or delayed treatment which was prompted by new information about their condition," said Dr. Eggener.
Dr. Eggener's study is in the Journal of Urology.
First Published: Mar 16, 2009 10:40 AM CST
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