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Prostate Cancer

Observation

Active Surveillance

Prostate cancer is, in most (but not all) cases, a very slowly growing type of cancer. Because autopsy studies show cancer cells in the prostate glands of almost all men 90+ years old, it is often said that if a man lives long enough, he will probably develop prostate cancer.  Most men who have prostate cancer do not die of prostate cancer – this is especially true of men in whom prostate cancer is diagnosed late in life.

These facts lead to an attractive option for some patients: if a man has a small,  slow-growing type of prostate cancer and has a life expectancy of 10 years or less, he may consider not having any treatment at all for the cancer, at least initially.  We can often safely follow these patients conservatively by checking a PSA and performing an exam periodically. Sometimes follow-up biopsies are recommended as well. Treatment can of course be started at any time that the patient and physician choose as needed.

Pros & Cons

Pros: Cons:
No treatment risk or discomfort Curative therapy may be more difficult or impossible later
Good statistical chance of living without the effects of prostate cancer  
Option of treatment if cancer grows or spreads  
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