Watchful Waiting Effective for Low Risk Prostate Cancer

"Watchful Waiting" may be more appropriate in men with low-risk prostate cancer than the common method of treating with surgery or radiation therapy, according to a research team at the University of Michigan in Ann Arbor.

The results of the study conducted by lead researcher Dr. John T. Wei and his associates have been published in the Journal of the National Cancer Institute. Their studies have revealed that watchful waiting or "expectant management" which includes regular checkups to see if treatment is necessary is a better option for men with early-stage prostate cancer.

The study states, "Just as a failure to treat a potentially lethal prostate cancer is generally considered inappropriate from a quality-of-care perspective. Aggressive treatment of indolent cancers (i.e., overtreatment) may also reflect suboptimal care in that it confers risk to patients and increases costs without providing health benefits."

The team led by Wei evaluated information in national databases and identified 71,602 men diagnosed with localized or regional cancer of the prostate between January 2000 and December 2002.

They categorized the risk to the patients from their cancers according to how well differentiated the tumor was rather than spread-out with indistinct boundaries.

The "lower risk" prostate cancer group were said to be men of any age diagnosed with well-differentiated tumors or men 70 years or older at diagnosis with moderately differentiated tumors."

The study revealed that about a third of subjects were classified as having lower risk cancer. Although good candidates for a watchful waiting approach, 55 percent underwent immediate treatment with 45 percent of them having received radiation therapy and 10 percent having undergone surgical removal of the prostate both of which could be considered as over treatment.

According to Wei's team "initial expectant management need not be a permanent treatment choice, and that some men, particularly younger patients, should eventually proceed to appropriate curative therapy after a period of asymptomatic expectant management."

They therefore recommend "active surveillance with delayed intervention as an appealing approach to addressing over treatment concerns among men with lower-risk prostate cancer."