WATCHFUL WAITING: A POINT OF VIEW

DR. GERALD CHODAK states some of the things to be taken into account in arriving at a decision to watch and wait:

"The growing recognition that watchful waiting or conservative management of clinically localized prostate cancer offers nearly similar disease-specific survival rates at ten years poses a major problem for both physicians and patients. Counseling patients will require a careful explanation of the risks and benefits from both conservative and aggressive treatment. In order to possibly gain a few years of survival, patients must be willing to endure a significant percentage of adverse effects for a long period of time which may substantially impair their quality of life."

"---- both radiation and (surgical) therapy will probably increase life expectancy by several years in a small fraction of men, have little or no effect on a large percentage, and significantly lower survival in the remainder. Because of our current inability to identify which patients will most benefit and which patients are least at risk, each individual confronting the choice of management will have to determine what reduction in quality of life we are willing to risk in order to have a small chance at significantly prolonged survival."

The above quotes are taken from "Treatment of Early Stage Prostate Cancer: Conservative Management - Delayed Therapy" by Dr. Gerald Chodak. The article can be found in "Important Advances in Oncology 1994", published by J.B. Lippincott Co., Philadelphia.