There was an interesting personal story in Monday’s Washington Post (as told by the patient’s wife) of one man’s journey toward the decision to manage his prostate cancer with active surveillance.
Obviously active surveillance is “not for everyone.” However, what The “New” Prostate Cancer InfoLink finds interesting about this tale is the apparent willingness of two, clearly well informed and skilled urologists to simply “blow off” the possibility that active surveillance was even an acceptable strategy for a patient like this.
It is certainly the case that the very high quality MRI scanning capabilities at the National Cancer Institute (where this patient enrolled in an ongoing clinical trial) can facilitate the decision to place a specific patient on active surveillance. It is also true that most urologists do not have immediate access to technology of this quality. However, …
The real question that this patient’s tale brings to light is the one of why — after some 20 years of research showing that immediate treatment is not always in the interests of an awful lot of men with low-risk, localized prostate cancer — immediate treatment is still the de facto recommendation presented to the majority of such patients?
If patients are not clearly advised of their choices, they can not make wise decisions. One of the two urologists referred to in this article clearly goes out of his way to try to inform his patients about the risks and benefits of PSA testing as well as of the different types of treatment that might be appropriate … but apparently even he was unwilling to bring up active surveillance.