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What to do with early stage prostate cancer has been a dilemma for years and will undoubtedly continue as such for the near future. Since prostate cancer is almost inevitable in every male sometime in his life, what to do with minimal disease is the dilemma. Or more appropriately, how do we identify those with early stage disease who without much treatment or no treatment at all, will not suffer and die from the disease.

The current study is a review of men in Connecticut aged 55 to 74 years and diagnosed in the seventies and early eighties. Thus, they have been followed for over twenty years. Basically the study concludes that aggressive treatment for localized low-grade prostate cancer is not warranted.

What this really means is that a patient who is diagnosed with early state disease and that the biopsy diagnosis reveals low-grade cancer needs to have a serious discussion with his physician about immediate and subsequent treatment. You always must keep in mind that the results of a study like this are statistical and not absolute in an individual case. This means that there are some patients in the study with early stage, low-grade cancer who did have problems with disease extension and death.

Presbyterian Cancer Center offers a second-opinion clinic (The Prostate Multidisciplinary Clinic) that is a resource for patients who want to get a full perspective of their disease.

Reference: Albertsen PC, Hanley JA, Fine J. 20-Year Outcomes Following Conservative Management of Clinically Localized Prostate Cancer. JAMA 293 (17), 2095-2101, 2005.