In writing this article, I realize the message is being delivered to a community of women – but it is vitally important. And because you are great communicators, my hope is that you will help distribute it to the men in your lives who need to hear it. If a loved one is suspected of having prostate cancer, it is extremely important for him to be seen by a urological specialist who can not only determine the presence of cancer but most importantly, its degree of aggressiveness. Doing so can prolong, and in many cases, save lives.
A recent study published in the Journal of the American Medical Association compared active surveillance (known often in the mainstream media as ‘watchful waiting’) and surgical cancer removal in a group of men diagnosed with prostate cancer. The purpose of the research was to learn more about the life expectancy of patients with this disease and the outcomes for those who chose one treatment approach over the other. What the study found for those who died was that the cancer was the cause of death for 28 percent of the men in the ‘watchful waiting’ group and 18 percent of the deaths in the group who chose surgical removal of the cancer. That’s a 10 percent difference between men who chose immediate surgical treatment and men who chose to wait.
In the news today, there remains a large difference of opinion between some non-medical groups who minimize the need for prostate cancer screening and us physicians who know what a wonderful gift an early diagnosis can be. Because the bottom line is this – patients who are not diagnosed at the early stages of prostate cancer have a higher chance of dying from it.
This article is not designed to minimize the active surveillance approach. In some cases, it can absolutely be the best course of treatment in that moment. But I have counseled too many patients who took that approach, only to find at a later date that their cancer was more aggressive than originally thought. The worst is when I have to tell a patient that the wait was too long and his prostate cancer has spread and is now incurable. When active surveillance is done properly, a physician can direct his or her patient to surgery or other types of treatment before the incurable happens.
So how do we know which prostate cancers are aggressive and which aren’t? There’s really only one way to accurately find out – a biopsy. Without this critical test, physicians don’t really have any consistently accurate way of telling the difference between prostate cancers that are “high-grade and aggressive” or “low-grade and minimally-aggressive.” Having complete knowledge of the cancer and how it behaves is the best way to determine the treatment recommendation for patients.
For those prostate cancers that are aggressive and progressing quickly, curative types of treatment including robotic surgery can be very beneficial. For less aggressive types of prostate cancer that are slow growing, watchful waiting may be the best initial course of action. But making sure that the men in your life remain consistent with their follow-up appointments is critical to the success of this approach. Even missing one or two follow-up appointments can mean the difference between a cancer that is still contained and treatable and one that has spread to other organs and has become incurable.
Ladies, the prostate health of the men in your life is important, even if they don’t like talking about it. Advancements in technology on both the diagnostic and treatment side of the prostate equation, especially in the case of robotic surgery, have made it such that the side-effects many men are initially concerned about are minimized or eliminated altogether. Finding a physician who is experienced in using the technology is critical because it gives each patient a chance at the best possible outcome – a prolonged and healthy life.