A recent report coming from research at Johns Hopkins University demonstrated that men with very low-grade prostate cancer may be able to be observed closely for any progression and avoid or delay treatment. The study included over 700 men with localized prostate cancer that was very low-grade or not very malignant who were followed every six months with PSA testing and a rectal exam and a prostate biopsy every year. Since 1995 none of the men has died from prostate cancer. One-third of the men had to undergo subsequent treat five or even 10 years later because their PSA increased for their biopsy showed a more aggressive form of cancer was present in the prostate gland.
Nearly 60 percent of men enrolled were able to defer treatment for 5 years or longer and > 40 percent were able to defer treatment for 10 years or longer. This means they were also able to defer all risks associated with active treatment (incontinence, erectile dysfunction, bowel problems associated with radiation therapy, etc.).
Bottom Line: This study offers good evidence that watchful waiting may be an option for older men diagnosed with a very low-grade prostate cancer. However, these men must be committed to regular follow up.