(From Research Summary) Watchful Waiting: Outcomes and Treatment Recommendations for Older Men

Categories: Spring 2007

Background: Limited information exists on the outcomes of watchful waiting or active monitoring in men with prostate cancer (CaP). We are most interested in determining if older men can skip treatment and do watchful waiting.

Question: What were the outcomes of men in our PSA screening study who were diagnosed with clinically localized prostate cancer and who chose watchful waiting (WW) as their initial treatment management?

What We Found: In the men who initially chose to manage their diagnosed CaP with watchful waiting, 36% showed evidence of biochemical progression and underwent additional treatments. So far, no patient in the additional treatment group died of prostate cancer.

Further study is needed to show if treatment for older men diagnosed with prostate cancer should start right away with hormones or radiation, or if they just should be actively monitored with no other treatment until they show cancer progression.

Study: From 1989 to 2001, we enrolled 35,000 men in a prostate cancer-screening program. Over those years, 3,565 men were diagnosed with CaP, and 347 (10%) chose watchful waiting (WW) as their primary management. The average age of this WW group was 75, with men from 48 to 90 represented. Patients enrolled in this study, those treated, and those in WW have been followed and this study is still ongoing.

Bradley . Erickson, MD, Chicago, IL; Kimberly A. Roehl, St. Louis, MO; William J. Catalona MD,, Chicago, IL; Brian K. Suarez, St. Louis, MO

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