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‘Wait and See’ Approach to Prostate Cancer Treatment

Although quick actions may save lives in the emergency room, rapid decisions aren’t always right for other patients—including men with prostate cancer.Prostate cancer occurs mostly in men older than 65, although younger men can be diagnosed with it. It affects the gland located below the bladder and in front of the rectum.

Symptoms of prostate cancer can include a frequent need to urinate and a weak stream of urine. Screening tests, such as a rectal exam or blood test, can check for prostate cancer before it causes symptoms. A man should discuss the advantages and limitations of screening with his doctor beginning at age 50. African-American men or men with a family history of prostate cancer should begin speaking with their doctors at age 45.

“I discuss with my patients the potential risks and benefits of prostate screening, including the limitations of the PSA test and digital rectal exam,” says Pierre Ghayad, MD, urologist at Riddle Hospital. “After this discussion, we jointly decide whether to continue with the screening.”

Many treatment options are available for men with prostate cancer, including surgery and radiation. Another choice is ‘watchful waiting,’ sometimes called observation or surveillance. Men who choose this option delay their treatment until symptoms appear or change.

Here’s why waiting can be an option: Unlike some other cancers, prostate cancer usually advances slowly. It can take 10 to 30 years for a tumor to grow. So, some men with early-stage prostate cancer choose to wait and see before starting treatment. By doing so, they avoid treatment complications—such as impotence and incontinence—that could affect their quality of life.

Watchful waiting isn’t for everyone.

“For patients with a more aggressive disease, both surgery and radiation therapy would be considered,” advises Jessie DiNome, MD, radiation oncologist at Riddle Hospital. “Radiation oncology treatment options would include either a radioactive seed implant which treats from within the prostate or external beam radiation therapy, which is delivered from outside the body.”

Remember, there’s usually no need to rush into a decision unless there are signs that the disease is progressing. Depending on what his physician says, he may have several months to research his options and speak with other men diagnosed with prostate cancer.

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