An expert panel convened by the U.S. National Institute of Health says men with low-risk prostate cancer can wait to see if their disease progresses before starting treatment.
The panel endorsed a active monitoring as possessed to immediate treatment, which can lead to impotence and incontinence.
After skin cancer, prostate cancer is the most common form of cancer in men in the United States. According to the Centers for Disease Control and Prevention, in 2011 approximately 240,000 men will be newly diagnosed with prostate cancer and 33,000 will die of the disease.
More than half of the cases of prostate cancer are localized – confined to the prostate – not aggressive at diagnosis and is unlikely to become life threatening, the panel said. However about 90 percent of patients receive immediate treatment, such as surgery or radiation therapy.
Those treatments have many damaging side effects including diminished sexual function and loss of urinary control, without clear benefits like improved life span.
“It’s clear that many men would benefit from delaying treatment,” said Dr. Patricia A. Ganz, conference panel chairperson and director of the Division of Cancer Prevention and Control Research at the Jonsson Comprehensive Cancer Center at the University of California in Los Angeles.
There are currently two alternatives to immediate treatment for low-risk prostate cancer: observation with and without the intent to cure.
Observation without intent to cure, sometimes referred to as watchful waiting, is a passive approach, with treatment provided to alleviate symptoms if they develop. Observation with intent to cure, often referred to as active surveillance, involves proactive patient follow-up in which blood samples, digital rectal exams, and repeat prostate biopsies are conducted on a regular schedule, and curative treatment is initiated if the cancer progresses.
The NIH is currently considering dropping the term “cancer” from this very early stage of the disease. Experts believe it may make it easier for men to accept the process of careful monitoring for changes as a better approach for them than immediate treatment.