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Is Treatment Necessary For Prostate Cancer?


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Do I need treatment for prostate cancer? The watchful waiting approach

Many men ask the question: 'is treatment necessary for prostate cancer?'  Well the short answer is that not all men diagnosed with prostate cancer need treatment. When considering whether to treat prostate cancer in a patient, an urologist will consider the following circumstances:

The grade of the prostate cancer1
A prostate cancer grade determines how quickly the cancer is likely to spread. A grade of 6 out of 10 is considered a low grade cancer unlikely to grow quickly or spread to other parts of the body2. A biopsy of the prostate cancer cells will be needed to determine the grade2.

The stage of the prostate cancer
The stage of prostate cancer refers to how big the tumour is and whether it has spread to other parts of the body2. At stage 1 the cancer is contained within the prostate and has not spread to other parts of the body. In most circumstances, the higher the stage of the prostate cancer the more treatment the patient will need.

Patient’s health and age
The patient’s general health and age will also be considered when determining whether to treat prostate cancer with surgery. The watchful waiting approach is more common in older men over the age of 65. For an older man, with a diagnosis of prostate cancer at a low grade and stage, it may be that he outlives his prostate cancer without experiencing any significant symptoms.

How is prostate cancer monitored? Active surveillance

Prostate cancer left untreated is closely monitored for signs of tumour progression. This is often referred to as active surveillance or watchful waiting1. Patients will need regular blood tests to monitor their prostate-specific antigen (PSA) levels, as a rising PSA level would indicate that the tumour is growing. Prostate biopsies will also be needed to assess the grade of the tumour. Prostate cancers initially given a low grade, where the tumour is growing very slowly, can change into fast progressing tumours at any time1.

Mr Christopher Eden
Consultant Urologist

References:
1. NHS Choices – Prostate cancer treatment. Date last updated: 14.02.2011. Website:
www.nhs.uk/Conditions/Cancer-of-the-prostate/Pages/Treatment.aspx
2. Macmillan Cancer Support - Prostate Cancer. Date last updated: 01.02.2010. Website:
www.macmillan.org.uk/Cancerinformation/Cancertypes/Prostate/Symptomsdiagnosis/Gradingstaging.aspx

 

10517 February 2012

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