Prostate Watchful Waiting Update: Safe Option or Not?

The "watching waiting" debate continues. Now comes a recent Wall Street Journal "Health Journal" article saying "there's increasing evidence that watchful waiting is a safe option for 30% to 50% of men with newly diagnosed prostate cancer." Several cancer centers are now conducting studies to determine which patients are the best candidates for watchful waiting. This summer, a multinational trial, with funding support by U.S. and Canadian National Cancer Institutes, will start recruiting some 2000 men to evaluate watchful waiting compared with other treatment strategies. Proton therapy, one of the preferred treatment options for men seeking to minimize potential side effects, has treated about 7,000 men in the past 15 years in a clinical setting. M.D. Anderson's newly completed proton center will begin treating prostate patients in May while the new Florida Proton Therapy Institute will begin treatments in July. While there still is no consistent standard for what constitutes a "good risk" prostate cancer patient for watchful waiting, it is typically advised for more senior men (late sixties and older) depending on their PSA and Gleason scores. Quality-of-life factors are also important for men who consider the strategy of monitoring themselves every few months while there are those who find walking around with the disease a psychological burden.

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