Fighting Prostate Cancer by Doing Nothing

I wrote in March about the controversies regarding prostate cancer screening, and I made the point that, unfortunately, it is still not clear whether or not diagnosing prostate cancer early saves lives.

This week’s Los Angeles Times Health Section features a fascinating article by Susan Brink that highlights the limited scientific evidence, and therefore the many reasonable options, available to prostate cancer patients. She discusses several healthy men diagnosed with early prostate cancer who have researched their options and have chosen active surveillance. Active surveillance involves frequent monitoring of the cancer through blood tests, ultrasound, and even biopsies, but with no intervention to treat the cancer.

Given the lack of evidence that current treatments like surgery or radiation prolong survival in early prostate cancer, the option of active surveillance is entirely rational.

“Most of the time, I tell men that they may need treatment, but they’re not going to die,” says Mark Scholz, a Marina del Rey oncologist, specializing in prostate cancer. “A lot of men with low-grade cancer may not need treatment for five to 10 years.”

Some may never need it.

I recommend reading the article, especially the excellent summary at the end of the different available treatments.

The important thing to remember is that prostate cancer is very common and grows very slowly. A new diagnosis is not an emergency. There is plenty of time to collect opinions from oncologists, urologists, and radiation specialists, collect your thoughts, and then decide what to do. Even if it’s nothing.

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