Two weeks ago, The New York Times published a story about a change in the way prostate cancer is treated. Today, almost half of men diagnosed with early-stage prostate cancer are able to avoid surgery and radiation by making an informed choice to opt for active surveillance instead. Active surveillance, also called watchful waiting, involves regular monitoring of the cancers, but no active treatment. Several years ago, the landscape of prostate cancer treatment was much different, with the majority of men choosing surgery or radiation. So what’s changed? To answer quite simply, the practice of medicine.
Twenty-three years ago, almost to the day, The New York Times published a story reporting the findings of the Prostate Patient Outcomes Research Team (PORT), which included the Foundation’s cofounders (Al Mulley and Jack Wennberg), a past president (Jack Fowler), and our current president (Michael Barry). After modeling three interventions for early-stage or localized prostate cancer (radical prostatectomy, external-beam radiation therapy, and watchful waiting), the PORT concluded that watchful waiting is a reasonable alternative for many men with early-stage prostate cancer when both clinical evidence and sensitivity to patient preferences are taken into account. “Our conclusion certainly challenged conventional wisdom,” said Michael Barry. “But when you look at the evidence, the benefits of treatment with surgery or radiation, for most men, are small enough to suggest that it’s really a preference-sensitive decision and that patients should be involved in the process of making that decision.”
In the years since that publication, the prostate cancer treatment (and diagnosis) debate has continued. But the movement to inform and involve patients in their care decisions has strengthened, ultimately changing the practice of medicine. It’s our mission to help people make better health decisions, and when men can choose the care they need and want for their prostate cancer, we’re achieving that simple mission.