'Watchful Waiting' and Low-Risk Prostate Cancer
Study finds 12 percent or fewer getting active surveillance
Older men -- those over 60 -- were more likely to have active surveillance. Men without insurance were also more likely to have active surveillance, the study said.
The researchers found that watchful waiting was most common on the West Coast and in the Northeast. The states with the lowest levels -- under 5 percent -- were Alabama, Mississippi, Tennessee and Kentucky.
Dr. Stephen Freedland, a urologist and director of the Center for Integrated Research in Cancer and Lifestyle at Cedars-Sinai Samuel Oschin Comprehensive Cancer Institute in Los Angeles, pointed out that the report's data is outdated. The situation has "changed dramatically" over the past few years, with early research suggesting that many more men are choosing the surveillance option.
Before, he said, doctors chose treatment instead of monitoring because they weren't comfortable with watchful waiting and "didn't fully appreciate how well the patients do; how safe it is to do that."
He said it's rare for patients to simply never come back after being diagnosed.
Also, he said, "there was no imperative, no push to do it. It's a counterintuitive thing to say 'You have cancer, but I'm not going to do anything.'"
So, where does that leave men with low-risk prostate cancers?
"Prostate cancer, even the lethal form, is highly treatable when it is detected at an early stage through the use of screening," Zhu said.
"Men aged 55 to 69 years who are considering being screened for prostate cancer should have a discussion with their physicians which involves weighing the benefits of preventing death from prostate cancer against the known potential harms associated with screening and treatment," Zhu added.
The report was published online June 29 in the journal JAMA Internal Medicine.