Prostate cancer watchful waiting

In the bicalutamide prostate cancer programme, the adjuvant treatment of patients with advanced prostate carcinoma (T1-T4 NO/NX, MO) with bicalutamide (150 mg, once a day) was evaluated. 4052 patients were randomised to bicalutamide with best standard care (either radiation, prostatectomy or watchful waiting ), whereas 4061 patients received a placebo with best standard care. An initial reduction of prostate cancer recurrence, which was observed in an interim analysis, later was not confirmed [219]. As the survival time in the bicalutamide treatment group was decreased, the study was terminated ahead of time. 

Treatment options for clinically localized prostate cancer include radiation therapy, surgery, or watchful waiting. There is currently no evidence to suggest which therapy is the most cfinicaUy effective, and treatment choice is often made by patient or physician preference. However, there are large economic differences in the therapies, with the cost of a radical prostatectomy 12,000 more expensive than watchful waiting, and radiation therapy 15,000 more expensive than watchful waiting. ... 

Schroder EH, de Vries SH, Bangma CH. Watchful waiting in prostate cancer review and policy proposals. BJU Int 2003 92 851-859. 

Demichelis F, Fall K, Perner S, et al. TMPRSS2 ERG gene fusion associated with lethal prostate cancer in a watchful waiting cohort. Oncogene. 2007 26 4596. 

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