According to a 15-year study., most patient diagnosed with prostate cancer at a very early stage will choose surgery or radiation treatments with the adverse effects of impotence or incontinence. About 10% choose no treatment at all, this is called watchful waiting or active surveillance or expectant management, normally not recommended by their doctors. The study, published in New England Journal of Medicine, found that patients with early stage prostate cancer survived the disease whether they opt for surgery or not.
731 men diagnosed with prostate cancer after having high PSA levels were randomly assigned to radical prostatectomy or observation and followed through January 2010. They found that radical prostatectomy did not significantly reduce all-cause or prostate-cancer mortality, as compared with observation. More than 1 in 5 in the surgery group had adverse effects from their operation.
The study suggests that most prostate cancers are not life-threatening, but most patients are given radical prostatectomy and they believe that treatment will eliminate the risk. Many men report pressurised by their doctors and families to seek aggressive treatment. The lead author of the study said the study shows that observation can be a wise and preferred option for most men diagnosed with prostate cancer detected with PSA.
However not all experts agree with the study's conclusion, but all feel that more research is needed to identify which cancer would be harmless and slow-growing. Some said that education and teaching is needed to understand the concept that not all cancers are the same.
Source : Radical Prostatectomy versus Observation for Localized Prostate Cancer. New England Journal of Medicine 2012; 367:203-213 (July 19, 2012), Abstract only, full text via Athens 90 days after publication.
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