Who Needs Prostate Cancer Treatment?

Thursday, October 17, 2013 - 9:43am
Assistant Professor of Oncology, Department of Urology

A topic of much debate nationally for years has been the role of “active surveillance” or what used to be called “watchful waiting” for many men diagnosed with prostate cancer.

Prostate cancer is typically a very slow growing cancer. The idea of active surveillance is that some men who are a bit older in age have a strong chance of not needing any surgery or other treatment, because the cancer will pose no likely risk to them prior to their natural deaths. It is based on the idea that these men are much better off living a high quality of life, without risking potential or actual side effects and stresses of cancer treatment.

Statistically, approximately half of all prostate cancer diagnoses are low grade and likely do not require invasive treatment. Many of these patients have, in fact, excellent prognoses and would benefit most readily from observation and non-invasive management of their disease. Even of the remaining 50 percent of diagnosed men with higher grade disease who undergo direct treatment via either surgical resection or radiation therapy, we find that many of these patients are being “overtreated” nationally, and would have benefitted from a more cautious approach to treatment.

At Roswell Park, we are pursuing more selective treatment options that we can provide these patients. The research that I am conducting is an attempt to isolate and define molecular markers that can help us make accurate distinctions about which treatment methods will most benefit a particular patient’s diagnosis.

Numerous studies nationally and internationally suggest that healthy, and cancerous cells may be constantly “shedding” from the primary tumor and carried through the bloodstream. Our research suggests that by taking blood samples, we may be able to identify the character of these cell fragments and determine what kind of threat they pose to a given patient.

With this research, we expect to use individuals’ cellular data to create targeted new drugs and treatment options that more efficiently combat a particular cancer, such as prostate and kidney cancer. These new approaches of the future will allow us to provide cancer treatment in a manner that is least harmful to the patient with the swiftest recovery period.