In an article on our soon to be “released” prostate cancer website I review all of the treatment options available. For elderly men, those between 65 and 80, with low to medium grade prostate cancer, “watchful waiting” is often considered to be a reasonable option.
The logic behind watchful waiting is that if the cancer is a slow growing cancer, the chances are that an older man will likely die from some other cause before the cancer is really a mortality risk. By being “watchful” or monitoring the cancer, if the nature of the cancer changes or if it progresses further than a doctor and patient are comfortable with, it still leaves time and the option of other prostate cancer treatments.
In an article in PSA Rising, it is suggested that a study shows the mortality experience to be about 30% higher over a 12 year period in men who use the watchful waiting method as opposed to active intervention.
There were some questions left unanswered for me in the article. It seems to me that the “no news is good news” attitude could lead to a more lax attitude toward watchful waiting after a number of years. I admit that there is still a mortality issue to be looked at, but it could also be that watchful waiting loses some regiment after a while and that the increased mortality really is a result of those who have either quit being watchful or have become lax about it.
This thought is substantiated to some degree in a study that followed men for just over 6 years and found that there was no significant difference between those who had more radical treatment and those who employed watchful waiting. Remember that watchful waiting is most often suggested only in older men with low grade cancer. The mortality experience began to change after that 6 year period.
This, from my simplistic point of view, tells me that if watchful waiting is your choice, rather than becoming more confident and relaxed with time, perhaps being more vigilant is really what is needed. Prostate cancer is still a very curable cancer, and if actively treated when it first shows signs of becoming more aggressive, there shouldn’t be any reason to expect anything other than an acceptable result.
Bottom line. From a life insurance standpoint, watchful waiting is not an avenue that will be accepted at all by most companies and probably not accepted with reasonable rates by any companies. While medically acceptable, underwriters really have a problem wrapping their minds around and binding their companies to coverage for someone who is actively not treating their cancer.