July 26, 2014

   A Publication of the James Buchanan Brady
   Urological Institute Johns Hopkins Medical Institutions

Volume II, Autum 2005

A Verdict in the Great Treatment Debate

What’s the best course of action — to treat prostate cancer, or to follow it carefully, treating specific symptoms? Many doctors, for many years, believed the question was moot, that either way, the results were about the same — that most men who were treated would die of the disease anyway, that many men who were not treated would die with their cancer, but not of it and ultimately, that prostate cancer was not really treatable.

This may have been true years ago, when men died at an earlier age from cardiovascular disease and when it was rarely possible to detect prostate cancer at a curable stage. But it’s not true today. Many striking advances have occurred over the last two decades, dramatically changing the picture. Among them:

  • Better management of cardiovascular disease has prolonged the lives of men, so that they now live long enough to potentially die from prostate cancer;
  • The development and wide spread application of a surgical technique has made it possible to cure prostate cancer; and
  • The ability to detect it sooner with more widespread screening, using the PSA test and the digital rectal exam, has made it possible to identify more men at a curable stage

For these reasons, men who are curable and who are going to live long enough to need to be cured are ideal candidates for surgical intervention. This doesn’t mean surgery is the only option; men should also consider watchful waiting and radiation therapy. But it does mean, says Walsh, “that men with prostate cancer should not put their heads in the sand and believe the old saying that everyone has it and no one dies from it.”

 

 

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