Should low-risk prostate cancer be treated or monitored?

June 27, 2018 | by Matthew Siegel, MD

Cancer can be confusing. We know it can spread if it’s not treated, so why do many recent studies say men who are diagnosed with a low-risk prostate cancer can take a wait and see approach?

Prostate cancer is a little different than other cancers. It can often be found early through a screening test, like a prostate-specific antigen (PSA) test or digital rectal exam (DRE). Because prostate cancer is usually not an aggressive type of cancer and most men have a slow-growing form that isn’t fatal, many men let it go untreated.

There are other reasons too: some prostate tumors grow at a slow rate, and could stay that way for a long time without spreading beyond the prostate. The long-term and life-altering side effects of going through treatment may not be worth the risk if the cancer is in a localized area.

In a recent study, researchers tracked two different groups of men for 10 years and found that only about 1% died from prostate cancer, even if they decided against surgery or radiation.

There are many important factors you need to consider when deciding whether to treat prostate cancer, including:

The stage and grade (Gleason score) of the cancer

  • Your age and expected life span
  • Any other serious health conditions you have
  • Your feelings and your doctor’s opinion about the need to treat cancer right away
  • The likelihood that treatment will cure the cancer (or help in some other way)
  • Your feelings about the possible side effects from surgery  or radiation 
If prostate cancer is unlikely to harm you, doctors may recommend active surveillance. During active surveillance, prostate cancer is carefully monitored for signs of progression. This usually includes a monitoring test every 3-6 months. Prostate biopsies may be done periodically as well.

Your doctor may recommend active surveillance if your prostate cancer:

  • Isn’t causing any symptoms
  • Is expected to grow slowly
  • Is small
  • Is only located in your prostate
If you are unsure of whether to treat prostate cancer or consider active surveillance, get a second opinion from a medical professional. A second opinion can help give you a different perspective and confirm a diagnosis. Edward-Elmhurst Health offers a Second Opinion Clinic, which is available to any patient who wants to better understand their diagnosis and treatment options.

Whichever option you decide, make sure you are comfortable with your choice. Whichever option you decide, make sure you are comfortable with your choice.

Related blogs:

5 questions men ask about prostate cancer

7 misconceptions about prostate cancer every man should know

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