Wait-and-Watch Approach Works for Some Prostate Cancer Patients

A study in the U.S. indicates that older men diagnosed with prostate cancer in the early stages can afford to keep tabs on the disease instead of going on for treatment immediately on diagnosis. The study, the biggest of its kind from the time the popularity of the PSA tests increased, was conducted on 9,000 men who had been diagnosed with prostate cancer, but opted to delay or avoid treatment.

Of the 9,000 men who were part of the study, only 10 percent died of the disease after 10 years. A significantly high number of the subjects were alive at the end of 10 years, without showing any major deterioration in symptoms. Those who did die did so as a result of other causes.

30 percent of the men in the study opted for treatment at a later stage, and were successful in delaying it by 11years, on an average. Led by Grace Lu-Yao of New Jersey’s Robert Wood Johnson Medical School, the study looked into the cases of 9,018 men with early stage prostate cancer diagnosis between 1992 and 2002.

The team obtained the data from the cancer database that the federal government maintains. The patients identified had no surgery, radiation, or hormone therapy for at least six months after the diagnosis of the disease, and many of them had not undertaken any form of treatment.

At the end of 10 years, the team discovered that the number of patients with low to moderate grade tumors who had succumbed to prostate cancer stood at only 3 to 7 percent, while those with high grade tumors stood at 23 percent. On the whole, just 10 percent of these patients had succumbed to prostate cancer.

Funded by the National Cancer Institute, the study has received a positive response from doctors. The American Cancer Society’s Chief Medical Officer, Dr. Otis Brawley, said, “It is important news. It may persuade some middle-of-the-roaders that we are over-treating this disease.”

Dr. Brawley said the problem was possibly being made to appear larger than it actually was, thanks to PSA testing. The PSA test has been widely prescribed since the 1990s in the U.S. to detect tumors in the early stages. While the test makes early detection of tumors possible, it is not a hugely recommended test since there is not ample evidence to suggest it actually leads to saving lives.

One of the biggest points of debate today in the medical world is about the treatment of prostate cancer. With more than 220,000 Americans diagnosed with the disease annually, prostate cancer is the most common form of cancer in the country today. However, the growth rate of the tumors is very slow, something that is a major factor in ensuring the disease is not life threatening.

The Annals of Internal Medicine carried a scientific review earlier this month suggesting that there was not enough evidence to recommend treatment as a more effective step than the wait-and-watch approach in the context of prostate cancer.

According to the new study, the good way to go for men over 65 years diagnosed with prostate cancer is to adopt the wait and watch approach instead of immediate treatment, according to review leader Dr. Timothy Wilt from the Minneapolis VA Center for Chronic Disease Outcomes Research.