WHAT TO DO IF YOU HAVE PROSTATE CANCER: CHOOSING THE WATCHFUL WAITING OPTION
Many urologists believe that a man in his late seventies or eighties with a limited life expectancy will most likely die of something else, so there is no need to expose him to treatment that will cause discomfort and pain plus incur considerable financial costs; in this case, the treatments may be more dangerous than the disease. Thus, watchful waiting is a preferred option for this patient.
Mark S. Litwin, Assistant Professor of Urology at UCLA, is studying the quality-of-life issues that face prostate cancer patients; he observes that what is most important to men is not the number of years they have left but the quality of those years. "An eighty-two-year-old man with prostate cancer who is completely potent and sexually active may prefer four years of potent, continent life to six years of impotent, incontinent life," Dr. Litwin observed.
Although many men die without even being aware that they have malignant cells in their prostate, this does not mean that a man with prostate cancer should just go on with his life and neglect the disease. Even if he has a low-grade cancer that is well defined and a low PSA for his age, he should still be monitored on a regular basis.
If, however, the patient has a significant cancer as shown by the results of the PSA test, biopsies, and ultrasound and he has a projected life expectancy longer than ten to twenty years, then the doctor will most likely suggest an operation or treatment appropriate for the stage of the disease.
The decision to wait or to seek treatment is not an easy decision to make, since prostate cancer does not follow die same growth pattern in each person. It behaves differently for each man, and it is almost impossible to compare the treatment between one patient and another.
Information to guide the doctor and patient is certainly needed. Strategies for early detection may cause a great deal of confusion if there are no clear answers about what to do if the patient has prostate cancer.
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