
                         Roanoke Times
                 Copyright (c) 1995, Landmark Communications, Inc.

DATE: THURSDAY, January 27, 1994                   TAG: 9401270017
SECTION: NATIONAL/INTERNATIONAL                    PAGE: A8   EDITION: METRO 
SOURCE: Associated Press
DATELINE: BOSTON                                LENGTH: Medium

STUDY LOOKS AT `WATCHFUL WAITING' IN TREATMENT OF PROSTATE CANCER

For many men with early prostate cancer, the best treatment may be none at all.

Prostate cancer is the most common tumor among men and their leading cancer killer after lung cancer. Recent victims include actors Telly Savalas, Bill Bixby and Don Ameche, and rock star Frank Zappa.

However, the proper treatment is a dilemma because the cure can be worse than the disease.

Many doctors routinely operate or give radiation treatment when prostate cancer is found, resulting in a variety of dreaded side effects. But a new study assesses another option - "watchful waiting" - doctors' phrase for doing nothing.

The study was an analysis of earlier findings in several countries. It found that men with early-stage prostate cancer who receive no treatment have an excellent chance of still being alive after 10 years, almost as good as those who undergo surgery or radiation.

"The message is not to abandon treatment," said Dr. Gerald Chodak. "But there are too many patients who are not being counseled about their options. This shows that watchful waiting is a reasonable option."

Just how reasonable, though, depends on several factors, including the patient's age, general health and the appearance of his cancer under a microscope.

For instance, a 75-year-old man with heart disease may opt against risking surgery, because chances are poor he will live more than 10 years, anyway. Surgery might seem more attractive for a 50-year-old.

Dr. John Libertino of the Lahey Clinic said he opposes watchful waiting for men in their 40s, 50s and 60s because of their relatively long life expectancies.

"If I had prostate cancer now, I'd want it out," said Libertino, 53. "I think that provides me the best chance of cure and control of the cancer."

Chodak, a surgeon at the University of Chicago, based his findings on an analysis of six separate studies of early-stage prostate cancer. The results are published in today's New England Journal of Medicine.

by CNB