Dr Art Hister – Watchful Waiting and Prostate Cancer

Yet another study (published in the Journal of Clinical Oncology) has concluded that for many cases of prostate cancer, “watchful waiting”, that is, doing nothing at all and just letting nature take its course, is as good a tactic as getting any of the most advanced therapies we have to offer.

In this study of 769 patients with a median age of 66 who had been diagnosed with the kind of prostate cancer that should not be overly aggressive (and remember, that’s the vast majority of prostate cancers), 1/3 of the men opted – as one would expect – for some kind of therapy, either radiation or surgery.

But 2/3 of these men opted for watchful waiting instead.

At the end of 10 years, the researchers concluded that doing nothing “caused no apparent harm,” meaning that the men who chose “watchful waiting” were just as likely to be alive and just as likely to not having had their malignancy spread as were the men who had opted for intervention.

Yet the key difference is that the no-treatment guys were way better off on average since they had clearly not suffered any side effects or complications from doing nothing as opposed to the men who had chosen radiation or surgery, both of which come with risks attached.

The bottom line: prostate cancer is very common but only kills or harms a small portion of the men who end up with that malignancy, especially if the men are over age 65, and although all of us are always eager to “treat” a cancer, sometimes that treatment should be “nothing”.

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