Prostate cancer, like any other cancer diagnosis, is an extremely hard thing for a man and his family to hear. Although often thought of as a ‘chronic’ or slow growing cancer, estimates are that over 33,000 men will die from prostate cancer in 2011, making it one of the top cancer killers in men. Yet, for many men, their prostate cancer very slow-growing, so it is possible it may never progress to the point where it interferes with their life or leads to death. A question that seems simple then, but really is very complicated, is how should localized prostate cancer (not advanced) best be treated, and is radiation treatment usually or always necessary?
A new study that offers some insights was published recently in the Annals of Internal Medicine. Researchers looked at 75 different studies of different radiation therapies in treating localized prostate cancer, determining the potential risks of radiation therapy versus not having radiation therapy at all. The researchers used active surveillance, which is just monitoring over time without intervention. It may sound scary to some people who think “you have cancer and you’re just not doing anything”! But what these researches discovered was no evidence that active surveillance was better or worse than having radiation right away for localized prostate cancer. To date, no randomized controlled trials (the Gold Standard) have been done that compare radiation therapy with no initial treatment- exactly the type of study that needs to be done.
Finally though, a clinical trial is currently underway, where half the people are being given radiation and half are having watchful waiting for localized prostate cancer. Until that result comes out, the take-home message here is that you need to have a detailed conversation with your doctor about the risks and potential of treatment versus watchful waiting.