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In the early 1990s, roughly 30 percent
of prostate cancer patients in the United States were
treated by surgery, 30 percent by radiation, and 20 percent
by watchful waiting. (Most of the rest were treated with a
combination of therapies). In Europe, by contrast, watchful
waiting constitutes the standard treatment for asymptomatic
prostate cancer.
The popularity of surgery in this
country has grown tremendously in recent years. A study of
Medicare patients' records found that the number of men
nationwide receiving radical prostatectomy by 1990 was six
times greater than the number recorded for 1984, and the
increase was seen in all age groups, from the youngest (that
is, age 65) to men in their eighties. Recent statistics,
however, indicate that since 1993, the rate of
prostatectomies has been dropping.
If you have prostate cancer, you need to
consider your age and general health before making a
decision about treatment. You also need to think about which
side effects you can live with. Some men, for example,
cannot imagine living with side effects such as incontinence
or impotence. Other men are less concerned about these and
more concerned about survival.
Treatment decisions are often hard to
make by yourself. No written information can take the place
of talking directly with your health care professionals. In
addition, talk with your family and friends and consider
getting more than one opinion. It is natural for surgical
specialists such as urologists to recommend surgery and for
radiation oncologists to recommend radiation. Primary care
doctors can help you choose the treatment that is best for
you.You might find that speaking with others who have faced
or are currently facing the same issues is useful.
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