Men Can Take Their Time To Decide On Prostate Cancer Treatment, Reports The Harvard Men's Health Watch
Main Category: Prostate / Prostate CancerAlso Included In: Men's health
Article Date: 05 Feb 2008 - 0:00 PDT
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Is it safe to wait to make a decision about having prostate cancer surgery, even after you've waited and waited for all the doctor appointments and test results? Or will the additional delay reduce your chances of being cured? Reassuring research says that men can take the time they need to make their decisions, reports the February 2008 issue of Harvard Men's Health Watch.
One study evaluated men newly diagnosed with prostate cancer who elected to have surgery. The men were divided into groups based on the amount of time that had elapsed between their diagnostic biopsies and their operations. The shortest period was 15 days, and the longest was 520 days. There was no correlation between the interval between biopsy and surgery and the risk of recurrence.
Another study divided men into two groups: those who waited less than three months and those who waited longer. As in the previous study, the time lag between diagnosis and surgery did not predict the risk of recurrence.
It's reassuring news, but does it apply to patients with a high risk for aggressive cancer? In the second study, the scientists identified high-risk patients, and even among these men, there was no link between delay and recurrence.
The Harvard Men's Health Watch suggests that if a man knows how he wants to treat his prostate cancer, there is no reason to wait. But if he's not yet sure, he can take the time he needs to read about prostate cancer, consult with experts, and talk with family members. It's a difficult decision, and it shouldn't be rushed. Prostate cancer is different from most cancers because it's usually slow-growing. Even aggressive prostate cancer cells take longer to multiply compared with most other cancers.
Harvard Men's Health Watch
http://www.health.harvard.edu
Visit our prostate / prostate cancer section for the latest news on this subject.
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Treating Prostate Cancer: No Rush To Judgment
posted by Gregory D. Pawelski on 12 Feb 2008 at 6:56 amThe prostate gland is unnecessary for life and is generally removed or destroyed with radiation therapy in patients with prostate cancer. This effectively deals with the localized prostate cancer, although the risk of serious side effects from therapy remains a big problem.
Prostate-specific proteins are not required for cancer cells to engage in malignant behavior. Prostate-specific proteins evolved to carry out functions important to the sexual reproduction of the human body. To cancer cells, prostate-specific proteins are unnecessary baggage.
Prostate cancer is a black hole. The problem is PSA (prostate specific antigen) testing. PSA testing is a bonanza for urologists. Lots more prostate cancer gets diagnosed. They get to do lots more radical prostatectomies. Urologists are adamant about recommending procedures that they themselves do.
The well-known phenomenon of "lead bias" may account for why a lot of earlier diagnoses provide misleadingly improved statistics, and are not really related either to treatment or to diagnosis. Prostate cancer is the best example of this. Breast cancer may be another example.
Improvements in overall survival for all patients are owing largely to a marked trend for earlier diagnosis and surgical technique. Even this doesn't mean that many more patients are being cured. If you diagnose someone earlier in the course of disease, of course they'll live long from the time of diagnosis. This is wha't known as "lead bias."
Many men with prostate cancer will never have symptoms or illness from their disease. Prostate cancer is an unpredictable, stochastic, evolutionary process. It is unknowable if early-stage prostate cancer will progress and cause clinical disease in a given patient.
I would want to see results of a prospective, randomized trial showing actual survival advantages (as well as a comparison of the cost in terms of treatment associated morbidity) before subjecting myself to the test and the possibility of then getting directed to biopsies and then getting directed to radical prostatectomy without any clear indication that this was in my advantage.
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