The American Urological Association (AUA) feels that the article by Johansson et al in the February 12th issue of the Journal of the American Medical Association, indicating comparable survival rates for localized prostate cancer patients who choose aggressive therapy and patients who opt for a "watchful-waiting" approach, presents a limited snapshot of the prostate cancer picture.
According to the AUA, a clearer, more comprehensive picture of prostate cancer survival is available in the treatment guidelines for localized prostate cancer released by the AUA in late 1995 and in a study by Gerber et al published in the August 28, 1996, issue of JAMA.
Aggressive Approach Advocated in Younger Men
The AUA treatment guidelines for localized prostate cancer were developed after an exhaustive review of the peer-reviewed literature. According to this comprehensive review, the available research data indicate that younger men and those with at least a decade or more of life expectancy should be aggressively evaluated and treated in order to decrease unnecessary death and suffering from prostate cancer.
Similar to Johansson and colleagues, the AUA prostate cancer guidelines recommend that treatment decisions should be based on the age and life expectancy of the patient, the characteristics of the patient's tumor, and patient preference. The guidelines strongly emphasize patient involvement in treatment decision-making, and they encourage urologists to fully inform prostate cancer patients about the potential benefits and risks of commonly accepted therapies, including surgery, radiation treatment, and watchful waiting.
The August 28, 1996, JAMA article by Glenn Gerber, md, and colleagues at the University of Chicago School of Medicine clearly associated radical prostatectomy with long-term survival in men diagnosed with early prostate cancer.