When men say “no” to treatment for prostate cancer, they don’t walk away feeling unburdened and free of concern. They’ve made a difficult decision and, as the diagnosis stays with them, they live with complex consequences.
Full Answer
What happens when men say “no” to prostate cancer treatment?
Choosing not to have treatment for prostate cancer has complex consequences. When men say “no” to treatment for prostate cancer, they don’t walk away feeling unburdened and free of concern. They’ve made a difficult decision and, as the diagnosis stays with them, they live with complex consequences.
Should I Have my prostate cancer treated?
While most men undergo some form of treatment for their prostate cancer, some men today choose to not be treated for their prostate cancer. Instead, they may choose to have their doctors monitor their cancer, especially if it's expected to grow slowly based on biopsy results, confined to the prostate, not causing any symptoms, and/or small.
Can we predict which prostate cancers will not progress?
Their difficulty predicting which cancers will not progress is reflected in current estimates drawn from the largest studies available, which say 41 per cent per cent of prostate cancers are not destined to cause illness or death.
Do you have a PSA test for prostate cancer without knowing it?
Some had their PSA (blood tested for prostate cancer) without their knowledge. They felt uninformed about their options and unsupported throughout the process of deciding what to do. Ultimately, this left them feeling disillusioned and distrustful towards the medical profession.
When do you not treat prostate cancer?
The study shows that “you have no business treating low-grade prostate cancer in someone with a life expectancy of less than 15 years” because the side effects outweigh any benefits, said urological surgeon Dr.
Can you have prostate cancer and not need treatment?
Low-grade prostate cancer may not need treatment right away. For some, treatment may never be needed. Instead, doctors sometimes recommend active surveillance. In active surveillance, regular follow-up blood tests, rectal exams and prostate biopsies may be performed to monitor progression of your cancer.
Why is treatment for prostate cancer unnecessary?
“About 70 percent of patients newly diagnosed with prostate cancer are in the early stages, meaning the cancer is confined to the prostate gland, and they have nonaggressive tumors. As such, these patients have an excellent prognosis without surgery.
At what age is surgery not recommended for prostate cancer?
Radical prostatectomy is the preferred treatment for men with prostate cancer that has not spread to other organs, but many doctors do not recommend the procedure for men over age 70 due to a perceived higher potential risk for complications.
Is it OK to leave prostate cancer untreated?
If left untreated, diagnosed prostate cancer can grow and possibly spread outside of the prostate to local tissues or distantly to other sites in the body. The first sites of spread are typically to the nearby tissues.
What happens if you leave cancer untreated?
For some people, the cancer can't be controlled anymore and spreads to healthy tissues and organs. Cancer cells take up the needed space and nutrients that the healthy organs would use. As a result, the healthy organs can no longer function. For other people, complications from treatment can cause death.
What happens if you do nothing about prostate cancer?
Most cases of diagnosed prostate cancer, however, if left untreated, will grow and possibly spread outside of the prostate to local tissues or distantly to other sites in the body. The first sites of spread are typically to the nearby tissues.
What are the signs that prostate cancer has spread?
Prostate cancer can spread to the lymph nodes in the groin area, or to other parts of the body. The most common symptoms are swelling and pain around the area where the cancer has spread. Cancer cells can stop lymph fluid from draining away. This might lead to swelling in the legs due to fluid build up in that area.
Is a high PSA level mean cancer?
An elevated PSA level doesn't necessarily mean you have cancer. And it's possible to have prostate cancer and also have a normal PSA level. Overdiagnosis. Some prostate cancers detected by PSA tests will never cause symptoms or lead to death.
What's a normal PSA level by age?
'Normal' PSA Levels By Age ChartAge Range (years)Baseline Age-Adjusted PSA Levels ng/mL40 to 490 to 2.550 to 590 to 3.560 to 690 to 4.570+0 to 6.5Oct 27, 2020
What happens if you stop hormone therapy for prostate cancer?
Most prostate cancers eventually stop responding to hormone therapy and become castration (or castrate) resistant. That is, they continue to grow even when androgen levels in the body are extremely low or undetectable.
What is the life expectancy with a Gleason score of 7?
Maximum estimated lost life expectancy for men with Gleason score 5 to 7 tumors was 4 to 5 years and for men with Gleason score 8 to 10 tumors was 6 to 8 years.
What happens if you say no to prostate cancer?
When men say “no” to treatment for prostate cancer, they don’t walk away feeling unburdened and free of concern. They’ve made a difficult decision and, as the diagnosis stays with them, ...
How many men were interviewed for prostate cancer?
For the study, published in the journal BMJ Open, researchers spent hours interviewing the 11 men to try to understand if and how they came to terms with their disease. All had biopsy-confirmed prostate cancer and all initially declined surgery or radiation, devising their own strategies instead.
How old was Jim when he was diagnosed with urology?
Advertisement. In one case study a man called Jim, who was diagnosed at 54 , said it took him ages to get his head around it. His encounter with the urologist was off-putting, especially as he was booked for immediate surgery without discussing alternatives.
How many men went on to radiation treatment?
Of the 11 men, two went on to have surgery and one progressed to radiation treatment. In their interviews, these men described significant uncertainty and angst about their decision to delay. They had a sophisticated understanding and recognised they would never know if they had made the right decision.
What did the CT scan reveal about the cancer in the hip?
The treatment was declared a success and he was sent home. But a year later he was in trouble. A full-body CT scan revealed potential secondary cancer in his hip. As the laser treatment had ruled out the surgical option, he struggled through hormone treatment and aggressive radiation.
Did the men in the interview have cancer?
At the time of the interviews, eight of the men were suffering no related physical problems. Several reflected on their increasing awareness that their cancer had not progressed, may never do so and might not be the life-threatening scenario that had been presented to them.
Who should talk to their doctor about prostate cancer?
Men who are at higher risk of prostate cancer – such as African-Americans or patients who have a family history of cancer – should talk to their doctors about any additional monitoring they should undergo, says Janet Farrar Worthington, who's co-written several books on prostate cancer.
How often do doctors do prostate MRIs?
For example, doctors at Johns Hopkins Hospital typically have a prostate cancer patient who's on active surveillance undergo an MRI every two to four years, Carter says.
How many men have prostate cancer?
About 60% are diagnosed in men ages 65 or older, and the occurrence of prostate cancer in men younger than 40 is rare. Prostate cancer is the second-leading cause of cancer death among men in the U.S., trailing only lung cancer. About 1 in 9 men will be diagnosed with prostate cancer in his lifetime. Overall, more than 30% of men who are diagnosed ...
What cancer did Clark Howard have?
April 9, 2019, at 5:22 p.m. Clark Howard was in Shanghai on a business trip in 2009 when his wife called him, tearful and anguished. A biopsy showed that Howard, then 53, had prostate cancer. When he returned home to Atlanta, his doctor recommended either surgery to remove his prostate gland or radiation therapy, ...
Is radiation necessary for prostate cancer?
That means the cancer is basically lacking the ability to metastasize and become life-threatening, he says. Consequently, the typical treatments for prostate cancer – radiation or surgery to remove the prostate gland – aren't necessary, Simons says. [. See:
Can prostate cancer become aggressive?
For patients on active surveillance, the concern isn't that their prostate cancer will become more aggressive, he says. Rather, someone with low-level prostate cancer is at risk of having another, more aggressive form of prostate cancer develop. "We don't want to over-treat, and we don't want to miss a second, more aggressive cancer," he says.
Is prostate cancer scary?
A diagnosis of prostate cancer can be understandably scary, but it's not a reason to panic, Carter says. It's crucial for men who are diagnosed with the disease to undergo the necessary tests to determine its aggressiveness, and to talk to their doctor to decide whether they need prostate cancer treatment.
How often do you have to have a PSA test?
Most Patients Did Not Progress. With active surveillance, the patients had physical exams and PSA tests every six months, with biopsies recommended every one to two years. Over an average of two and a half years of follow-up, 43 of the study participants showed evidence of cancer progression and received treatment.
How long after a first biopsy is a second biopsy done?
The second biopsy was done between 3.7-10.5 months after the first biopsy. As a result of the second biopsy, about 30% of the patients who were initially considered candidates for surveillance were excluded from the study because they ended up undergoing treatment.
Does prostate cancer spread beyond prostate?
In two patients, cancer spread beyond their prostate. The study is published in the April issue of the Journal of Urology. The findings support the idea that some men with prostate cancer may not need treatment, American Cancer Society Deputy Chief Medical Officer Len Lichtenfeld, MD, tells WebMD.
Can prostate cancer be treated without treatment?
Prostate Cancer Without Treatment. Eggener made it clear that not all prostate cancer patients with early-stage disease and a good prognosis are good candidates for active surveillance. In the United States, one man in six will receive a diagnosis of prostate cancer during his lifetime, but a much smaller percentage -- one in 35 -- will die ...
Why do men not undergo cancer treatment?
Others men may choose to not undergo cancer treatment because of a short life expectancy or other serious medical problems.
What is active surveillance prostate cancer?
Known as active surveillance, it is common when the cancer is expected to grow slowly based on biopsy results, confined to the prostate, not causing any symptoms, and/or small. In active surveillance, doctors will initiate cancer treatment only if cancer starts growing.
Where does prostate cancer spread?
Prostate cancer is known to have a particular affinity for spreading or metastasizing to the bones especially the lower spine, pelvis, and femur. 3 Other organs such as the liver, brain, or lungs can also be the sites of spread, but these are much rarer.
Is prostate cancer confined to the prostate?
With regard to prostate cancer, most cases of the disease are discovered while the cancer is still confined to the prostate itself. 1 This is called “local disease” or “localized disease.”. The disease is easiest to treat while it is confined to the prostate. At this stage, surgery and radiation are most likely to be curative ...
Can prostate cancer be treated?
The disease is easiest to treat while it is confined to the prostate. At this stage, surgery and radiation are most likely to be curative and completely kill or remove whatever cancer cells are present. 1 . If left untreated, however, prostate cancer can proceed on a number of different paths.
Can prostate cancer spread to other parts of the body?
If left untreated, diagnosed prostate cancer can grow and possibly spread outside of the prostate to local tissues or distantly to other sites in the body. The first sites of spread are typically to the nearby tissues.
Why do people with slow growing tumors feel the need to act?
This is because the word “cancer” makes the diagnosis feel urgent, and it is hard to feel like one is "doing nothing.".
Why is it important to hear the word "cancer"?
This is important because cancer treatment poses many risks for individuals, not the least of which are treatment-related side effects and long-term effects.
Can prostate cancer cause shortening of life?
In addition, we know that some cancers, such as prostate cancer, may not cause a person any serious harm or even shorten their lives if they are left untreated. The researchers in this study presented an imaginary scenario to volunteers using a web-based survey.
Can cancer be treated?
The researchers found that using the "cancer" label led many people to choose surgery. This tells us that the perceptions and fears associated with a cancer diagnosis may lead reasonable people to opt for more treatment, even if they are reassu red that it is possible to watch and wait and that they may never need treatment.
What to do when patient says no to treatment?
I care for my Father who was diagnosed with prostate cancer almost three years ago. Gleson 9. Spread to lymph nodes. His treatment has been working well up until recently and was suggested last week by the Consultant that chemotherapy would be next.
What to do when patient says no to treatment?
Hi there ... it sounds like you need a heart to heart and LISTEN to your dad ... l dont know his age but guess he's at least in his 60s ... I have breast cancer ... and although I had mastectomy I said no to radio even though I was grade 3, because of skin that doesn't heal well ...
What to do when patient says no to treatment?
Hello there spxppg; welcome to the forum. Sorry to learn about your dad. However the decision is of course his to make. You don't say how old your dad is but even if he is not elderly he may feel he has had enough and just cannot face any more treatment.
What to do when patient says no to treatment?
Hello spxppg, I was in a broadly similar position when my dad chose to end dialysis. He was 83, had had kidney failure for 3 years, and basically was tired of everything. My sister and I hardly ever agree on anything, but we both felt it was his choice to make, and supported him. He passed away knowing his wishes were respected.
What to do when patient says no to treatment?
A chat with your Dad may help make things clearer to you. My own Dad was diagnosed with Prostate Cancer at the age of 80 and was quite insistant (having listened politely to the options then available to him) that he did not want any treatment and would let 'nature take it's course'.
Feeling Frightened
Side Effects
- Some men were more focused on the side effects of treatment rather than death. As one put it, “I was very worried about the possibility of long-term incontinence. The idea of having to wear pads in my underpants for possibly the rest of my life was not attractive.” The study, which included men from around the country, was led by Professor Kirsten McCaffery, director of Sydney Health Literacy Lab, and one of the lead investigators at Wiser Healthcare, …
Uncertainty and Angst
- Of the 11 men, two went on to have surgery and one progressed to radiation treatment. In their interviews, these men described significant uncertainty and angst about their decision to delay. They had a sophisticated understanding and recognised they would never know if they had made the right decision. Their guilt, questioning and uncertainty was significant and unresolvable. One was Peter, who was diagnosed at 56. While he had resiste…
Questioning Decisions
- One of the men who decided on surgery was a medical doctor and fully informed of his options. He made the decision after receiving a blood result showing a high level of the marker for prostate cancer. Using frank language, he described how he couldn’t really tell if he had been over-diagnosed or whether the diagnosis and surgery saved his life. “There’s a part of me that wonders did I f--- myself up because I waited 3½ years or, did I f …
Changing Practices
- At the time of the interviews, eight of the men were suffering no related physical problems. Several reflected on their increasing awareness that their cancer had not progressed, may never do so and might not be the life-threatening scenario that had been presented to them. Some questioned whether alternative healing had helped or whether the outcome would have been the same regardless. “I’ve known for 5½ years that I’ve got cancer in me, …