Treatment Options For
Prostate Cancer Investigated - Is Invasive Treatment Better than
Watching and Waiting Approach - Symptoms
A new study is underway to determine if low-risk prostate cancer
patients do better or as well using the watchful waiting approach
compared to those that have invasive surgery. In this study 200 of the
650 patients needed have already enrolled. These men have been
diagnosed with low-risk prostate cancer at M. D. Anderson and are on
active surveillance for their disease, having changes monitored through
regular Prostate Specific Antigen (PSA) tests, biopsies and check-ups.
Now that men are routinely tested for PSA blood test beginning in their
40’s, thousands of men have had their prostate cancer detected at such
an early stage that managing low-risk disease through surveillance may
outweigh the risks and possible side effects of treatments. This is
what doctors at The University of Texas M. D. Anderson Cancer Center
hope to determine with their new study.
Jeri Kim, M.D said "With the advent of the PSA test, we see prostate
cancer detected much earlier but there is no evidence that early
detection means longer survival. Because of the sensitivity of the test,
clinically insignificant tumors sometimes are over-diagnosed and
patients may, as a consequence, be over-treated with radiation and
surgery.” Kim is the principal investigator of the study and assistant
professor in the Department of Genitourinary Medical Oncology at M. D.
The study will enroll 650 prostate cancer patients who have been
clinically defined either as low risk, or patients with localized
prostate cancer who have refused early intervention, or patients with
localized cancer who are precluded from therapy due to other serious
health conditions. Patients who have had previous treatment for their
prostate cancer are not eligible to participate.
The patients will have a biopsy at the beginning of the study to confirm
the diagnosis of localized prostate cancer followed by PSA tests and
digital rectal exams every six months. The need for additional biopsies
will be determined at the end of the first year of surveillance, and
participants on the study will be given a transrectal ultrasonography
annually to detect any possible changes.
Patients also will be asked to complete a survey on their general health
conditions as well as six other short surveys which will be used to
monitor diet and behavior as part of related research.
According to the researchers, prostate cancer is one of only a few
cancers that can be latent in the body for some time, not requiring
immediate treatment. Kim said “Many researchers have documented over
the years that men die with their disease rather than from it, and while
we need to intervene early, we also need to intervene appropriately with
respect to the stage of disease, the man's age, his health in general
and quality of life."
Most of the times there are no symptoms for prostate cancer early on.
This is why it is important to get a PSA test early. The earlier tests
will also help determine a baseline PSA which naturally goes up with
age. The rate of increase along with levels of PSA can help doctors
determine how fast the cancer is growing.
Some of the symptoms are: Frequent urination, especially at night,
inability to urinate, trouble starting or holding back urination, a weak
or interrupted flow of urine, painful or burning urination, blood in the
urine or semen, painful ejaculation, frequent pain in the lower back,
hips and / or upper thighs. These can be symptoms of cancer, but more
often they are symptoms of noncancerous conditions. It is important to
check with a doctor.
By Dan Wilson
Books on Cancer
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