Prostate Cancer: When Watching And Waiting Is Better

The decade-long debate over the best treatment for low-risk prostate cancer continues, with some researchers at John Hopkins med school persuaded that watching and waiting is the way to go for many men with low-risk cancer. Here’s why: just two of 1,298 men enrolled over the past 20 years in an active surveillance program died of prostate cancer, and three developed metastatic disease. Science Daily reports that all of the men in the study had cancer that was classified (in part by Gleason score) as low-risk or very low-risk. Of the 1,298 men, 47 died of nonprostate cancer causes,  nine of the 47 had received treatment for their prostate cancer. Two men died from prostate cancer, one after 16 years in the active surveillance program, and three were diagnosed with metastatic prostate cancer. The bottom line? The researchers calculated that men in the program were 24 times more likely to die from a cause other than prostate cancer over a 15-year span. Some 467 men in the group (36 percent) had prostate cancers that were reclassified to a more aggressive level within a median time of two years from enrollment in the active surveillance program. For men with very low-risk cancers, the cumulative risk of a grade reclassification to a level that would have generally precluded enrollment in the program over five, 10 and 15 years was 13 percent, 21 percent and 22 percent, respectively. For men with low-risk cancers, this risk increased to 19 percent, 28 percent and 31 percent. Over the same time frames, the cumulative risk of a grade reclassification to a level that would be considered potentially lethal  but still curable was no more than 5.9 percent for both very low and low-risk prostate cancers. Read more at Science Daily.