Stage 1 prostate cancer with Gleason less than 6 and PSA of 7?

[Tedebear]

Question for smart person.

Is it better to treat with radiation? Or surveillance?

Is there an algorithm to treat stage 1 prostate cancer?

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[gutonc]

Question for smart person.

Is it better to treat with radiation? Or surveillance?

Is there an algorithm to treat stage 1 prostate cancer?

Screw algorithms...there a whole fresh steaming pile of data from NEJM this morning. Feel free to draw your own conclusions.

 

[hot sauce]

It is an individualized decision. What's the actuarial life expectancy of the person? How comfortable would he be with active surveillance. How many cores were positive? What's the clinical T stage? Is he going to follow up?

It would not be wrong to offer active surveillance but if the the man wants treatment he will find someone who will treat.