Prostate cancer treatments more advanced than ever

How many of you know someone with prostate cancer? I am willing to bet that is almost everyone who is reading this article.

About 161,360 men will be told they have prostate cancer this year. It is the most common cancer in men (after skin cancer). The estimated lifetime risk for a man to develop prostate cancer is 1 in 9. I have discussed before the importance of discussing prostate cancer screening with your doctor. However, for those men diagnosed with prostate cancer, current treatment options are more promising than ever. I thought I would spend this column in discussing them with you.

One of the treatment options receiving the most endorsement is actually no treatment at all! There is an adage that states, "More men will die with prostate cancer than from prostate cancer." This means that just having prostate cancer does not mean that you will die from it. Certainly there are many prostate cancers that are diagnosed at an early stage and are of such low aggressiveness that they will never be a significant threat to a man during his lifetime. Now that does not mean that we simply ignore them, or pretend they don't exist. For these men, we recommend either "watchful waiting" or "active surveillance." With watchful waiting, we follow a man's PSA and prostate exam on a periodic basis. The ideal cancers for this more laidback approach are very low volume (small) and very low grade (non-aggressive) cancers. We know that these cancers have a very low likelihood of spreading and are not a threat to most men. With active surveillance, we take a more active approach. These patients have either a larger volume or more aggressive cancer but still with a low risk of spread. In these patients, we follow their PSA much closer, and will repeat their prostate biopsy on a periodic basis. This allows us to know if the cancer is growing or becoming more aggressive.