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Why The Best Treatment For Prostate Cancer May Be No Treatment At All

By Dr. Dave Hnida

(CBS4) - The best treatment for early prostate cancer may be no treatment at all. And that's an important change in thinking when it comes to the standard approach to men diagnosed with the disease.

Here's the gist of a new study from the New England Journal of Medicine.

Researchers began following men diagnosed with early stage prostate cancer in 1994, and compared how those who had aggressive treatment such as surgery or radiation did versus those who did nothing at all.

The result: no difference in death rates from prostate cancer--- meaning men who simply were followed had no higher rate of death from the cancer than the ones who went with treatment. And what makes that important… very important, is that about one in three men who underwent treatment had a lifelong, and life altering side effect from the treatment... such as incontinence or impotence.

blood test
(credit: CBS)

Also interesting was how the men who did nothing but "watchful waiting" were actually followed: not very aggressively. They did not go through annual exams or PSA blood tests. They basically checked in with their doctors if they developed any signs or symptoms of problems.

Now it's big-time important to point out that this study really only gave an opinion about how to approach men with low grade, non-aggressive cancer. But that's about 70% of men who develop prostate cancer, so we are talking about the majority.

However, the rules of doing nothing DO NOT necessarily apply to men with more aggressive or high-grade tumors. Those guys often do better with active treatment such as surgery or radiation---so the message of this study is not that every man with prostate cancer can simply forego treatment.

Instead it really means that a majority of men can probably be left alone, and simply followed… while others may be better served with treatment.

That decision is not a one-size-fits-all, but needs to be made on an individual basis when it comes most common cancer of men.

Here's what you need to know about the disease: cancer.org/cancer/prostate-cancer.html

Dr. Dave Hnida is CBS4's Medical Editor. He blogs about the latest studies and trends in the health world. Read his latest blog entries, check out his bio or follow him on Twitter @drdavehnida

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