When my brother, sister and I decided to get together this summer, it wasn’t for an exotic vacation in Europe or Hawaii. Instead, we took our spouses and children to a monumental celebration in, of all places, Davenport, Iowa! The family reunion, of sorts, was for the purpose of honoring and celebrating our dad’s 85th birthday.
It was a wonderful time of porch-sitting, pork-eating and gift-giving to the father who taught us so much about life, and loving life. Bucket lists? Our dad invented them. Trekking in the Himalayas, scuba diving off Grand Cayman Island, bicycling cross-country – he’s done it all. When he finishes one list, he just starts another.
But at age 70, when Dad got his cancer diagnosis, we all worried his current bucket list wouldn’t be completed. It was prostate cancer. He had two choices. Surgery or an option known as “watchful waiting.”
Hoping to avoid the possible side affects of prostate surgery, Dad chose the latter and 15 years later, the “waiting” continues to pay off. What a joy to watch Dad blow out the candles on his strawberry-rhubarb birthday pie – looking forward to number 86!
While men continue to make that delicate decision today, new studies are providing more clarity to make the choice a little easier.
No doubt, surgery to remove an early-stage prostate tumor does reduce the risk of metastases and death in patients compared with watchful waiting. But, here’s what probably spared my Dad. According to the recent results of a New England Journal of Medicine study, the benefits of surgery apply only to men under the age of 65. Dad got his diagnosis at 70, making him a perfect candidate to watchfully wait. As it turns out, most tumors found in older men grow slowly and those men will eventually die of causes unrelated to prostate cancer.
At a recent Palomar Health “Dine With the Docs” event, prominent north county Urologist Dr. Paul Neustein explained, “with watchful waiting (also known as expectant management), doctors actively and carefully monitor the patient for signs the cancer has worsened, treating symptoms of the disease when they occur.” This treatment strategy can help some patients avoid surgery to remove the prostate and related lymph nodes (radical prostatectomy) along with negative side affects including incontinence and impotence.
While researchers are encouraged, doctors warn that these recent study results should be interpreted with caution. Much more research is needed to definitively determine the benefits of watchful waiting.
I’m no doctor, but am encouraged by any option that can postpone or eliminate the need for major surgery. As for Dad? In a few months, he’ll be checking in with the doctor who’s been keeping a watchful eye on him for years, just to make sure nothing’s changed. What’s most important is the next item on his bucket list. A trip to Dubai! (I’m not kidding!) But it’s really no big deal. For Dad, it’s just another “trip of a lifetime!”
Contact Carol by emailing her at Carol@palomarhealth.org.