PROSTATE CANCER WATCHFUL WAITING

WATCHFUL WAITING
OR
CONSERVATIVE MANAGEMENT?

THIS SECTION IS UNDER CONSTRUCTION.....

Men who are diagnosed with prostate cancer are often urged to take immediate action. This usually coincides with their natural inclination and yet it may not be necessary for them to have invasive conventional treatment immediately. This rush to action is one of the main reasons that some experts regard the disease as being overtreated.

Fortunately there is a move away from this towards a more measured approach. More and more often men in the United States at least may be told that immediate action may not be necessary or in their best interests. Such men are said to be on Watchful Waiting. According to the latest statistics, about 30% of newly diagnosed men are in this position - about the same percentage as those who have each of the two major conventional treatments - radiation in its many forms and surgery, which can therefore no longer be regarded as the 'gold standard'.

A definition of Watchful Waiting is that it consists merely of close observation of the cancer, looking for any signs of progression with blood tests, scans and physical examinations. Specific cancer treatment will be undertaken only when problems arise from the cancer growth.

In other words, doing nothing.

That seems very foolish after diagnosis with a potentially fatal disease. There is also the negative connotation of the words themselves. They conjure up a picture of a small goat staked out as bait for a tiger or leopard hunt. Watching and waiting for the fatal attack and hoping that the hunters will manage to get a lethal shot in time.

Yet men in this position can do something. They don't have to wait helplessly for the deadly disease to leap into action. It may be possible to affect the progress of the cancer by ensuring that the immune system is able to work at optimum efficiency. Many suggestions have been made as to what to call such a course of action - Conservative Management seems to be the most widely accepted.

There may be better terms than Conservative Management, but at least it does have positive connotations, because it implies that something is being done to manage the disease. That the man is not passively waiting for something awful to happen. And "conservative" is a comforting word - nothing too radical - no leap into the unknown. With this approach the quality of life, which most regard as so important, can be conserved and maintained.

Conservative Management may be best achieved by trying to maintain a healthy balance in all aspects life - mental, physical and spiritual. The last item is as important as any, but is one that is usually shied away from. Perhaps that is because it skates on the thin ice of religion - a subject so often excluded from discussions despite its importance. Suffice it to say that getting a spiritual balance in our lives is very important. That doesn't mean just the regular attendance at a place of worship - it means living the life that our religious beliefs show us is right and just and finding the 'inner peace' that is a feature of all the major religions.

The question of such balance arises because the immune system is an enormously complex one with a multitude of functions. Yet, like all natural systems, it is finite. It can only cope with a limited number of problems at any one time - and then only if it has the right materials at hand. So, for example, if the scarce resources are diverted from their task of maintaining good health, there is a greater chance of illness developing. This problem is exacerbated if an unhealthy diet does not provide the required fuel for the system and if the routes by which the immune system cells travel throughout the body are clogged from overweight or lack of exercise.

Cells are replaced daily by their billions in our bodies. Inevitably, as in any large production works, there are some defective cells manufactured. The immune system normally collects these and destroys them as part of its function. If it is unable to do this, these defective cells will multiply and a disease like prostate cancer can and will develop. It seems logical that if the immune system is focussed and running at peak efficiency, then there is a chance that it will gain some control over the progress of the disease and slow it down. Perhaps even reverse the progress and cause the disease to regress.

There are laboratory studies that show that cancer cells, once established, are able to evade detection by some cells in the immune system. From this comes the belief that once cancer cells are formed, only intervention by invasive treatment can give any hope of cure. There seems to be little doubt that this may be true of cancers which are well established and which have been growing for some time and more especially for those which are classified as aggressive, with high Gleason Grades. But it seems not to be true of all cancers. There is a large body of scientific research that shows that spontaneous regression of tumours can and does occur. Spontaneous regression being defined as a complete or partial, temporary or permanent disappearance of all or at least some relevant parameters of a soundly diagnosed malignant disease without any medical treatment or with treatment that is considered inadequate to produce the resulting regression.

The main causes of malfunction of the immune system, apart from direct physical intervention such as radiation, are held by many to be:

1. Stress
2. Lack of proper physical exercise
3. Incorrect body mass
4. General unfitness
5. Poor eating habits.

Professor Dean Ornish gained fame for his work on heart problems. His regimen essentially tackles all the above issues and it is of interest to note that he is currently running a three-year study to test the effects of his heart program on early stage prostate cancer. He has two cohorts of men with similar diagnoses. One group is on Watchful Waiting and the other is following a plan that calls for meditation and other stress relieving programs, accompanied by regular exercise and a sound diet. The study has not been running for very long, but initial reports sound promising.

To be continued……..

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