Study: Some men with low-risk prostate cancer can put off treatment

UMass urology expert explains options compared in new research

By Sandra Gray and Bryan Goodchild

UMass Medical School Communications

August 06, 2013

Why would anyone diagnosed with cancer delay treatment? A recent study concludes that many men with low-risk prostate cancer should do just that, because they are likely to live just as long and enjoy a better quality of life, than those who initiate treatment immediately.

In the study, published in the Annals of Internal Medicine, investigators compared the costs and benefits of initial treatment versus observation via either watchful waiting or active surveillance. They found that both approaches to observation were more effective and less costly than initial treatment for men who were newly diagnosed with low-risk prostate cancer at ages 65 and 75.

“The first thing is to understand the disease. Understand that you don’t have the same cancer that every other man who is diagnosed with prostate cancer has,” said Jennifer Yates, MD, assistant professor of urology and director of minimally invasive urologic surgery at UMass Memorial Medical Center, who was not involved in the study. “The treatment has to be tailored to each individual patient.”

But how does one decide whether to undergo treatments?

“We look at the life expectancy and the medical issues of the patient,” said Dr. Yates. “Patients who are candidates for watchful waiting are typically older patients who have a shorter life expectancy and more medical problems. Patients who are candidates for active surveillance are men who we would expect to have a life expectancy of more than 10 years.”

And because most men who undergo treatment have at least one long-term complication, such as incontinence or erection problems, their values systems play an important role. “We’re talking about quality of life. We have to think of all these things together,” said Yates.

Whatever decision a man reaches with his doctor, the objective is the same. “We want them to live a long healthy life with as few complications of their prostate cancer as possible,” said Yates.

In this Expert’s Corner video, Yates explains what patients diagnosed with low-risk prostate cancer should consider, and the differences between watchful waiting and active surveillance.

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