It might be said that searching for prostate cancer in healthy men is bad medicine — and unlikely to extend the quality or length of men’s lives. It certainly has no effect on long term survival as shown in a recent study from the NEJM entitled: 10-Year Outcomes after Monitoring, Surgery, or Radiotherapy for Localized Prostate Cancer (check out our Quick Links section for a link to the article and an accompanying editorial from the NEJM).

The conclusion: at a median of 10 years, prostate-cancer-specific mortality was low, irrespective of the treatment assigned, with no significant difference among treatments. Surgery and radiotherapy were associated with lower incidences of disease progression and metastases than was active monitoring

Suffice to say, the options are many and one can conclude that in such situations, the best approach is again shared decision making. For the engaged patient, it is certainly useful - in the context of the vast unfiltered wasteland that is the Internet - to have reputable references to the best evidence. Take a look at the resources in the NEJM and help your patient understand what this means for them!