For every one man with clinically significant prostate cancer, at least 20 have prostate cancers that will never affect their life expectancies or the quality of their lives. However due to variety of factors, prostate cancer in the United States is treated in a very aggressive manor. Most American men of all ages will be offered radiation therapy or radical surgery for the treatment of their prostate cancer when for the majority of these very same men, active surveillance would provide similar prostate cancer mortality and morbidity rates without any of the significant and life altering treatment side-effects. The treatment side-effects from surgery include erectile dysfunction, ejaculation dysfunction, and incontinence. Radiation is also associated with sexual dysfunction and voiding dysfunction that can at times become incompacitating. In the past, many men who opted for watchful waiting were told they were "crazy." Finally outcomes data has proven that these couragious men were in-fact correct. Active surveillance has finally been shown to be a safe and effective form of therapy for the majority of men with prostate cancer, not just for the the minority of men with prostate cancer.
Men who meet the following criteria may be candidates for active surveillance:
PSA <= 10
Gleason <= 6
Depending on age and co-morbidities:
<3 cores positive for cancer, <50% of any one core involved
Additionally, new molecular diagnostic tests can be run on a patient's prostate cancer specimen from the lab to determine the "danger" potential of that specific tumor.
If you meet the above criteria and feel that you are being pressured into selecting one form of interventional therapy vs another (radical prostate or radiation), feel free to contact my office for a consultation. Or call us at: