June 12 —  When Alan Jones, the dean of Grace Cathedral — the biggest Episcopal Church in San Francisco — learned he had early-stage prostate cancer, he decided on a radical course of action: Do nothing. No surgery. No radiation. At least not for now.

“THE RESEARCH I read seemed to indicate that intervention doesn’t prolong your life anyway,” Jones said.

And it’s not just patients who believe that. Many prostate cancer experts like Dr. Peter Carroll of University of San Francisco Medical Center are saying a lot more men should be avoiding or delaying treatment.

“We’re getting the message that we’re over-treating patients. And we need to accept that message and act on it,” he said.

Often prostate cancer can grow slowly and not threaten a patient’s life. But most of the 190,000 men diagnosed every year get surgery or radiation that can have severe side effects — especially impotence and incontinence.

“It’s a huge cottage industry in this country built on prostate cancer,” said Dr. Thomas Stamey of Stanford University Medical Center.

Stamey thinks the problem starts with the PSA (prostate specific antigen) blood test. PSA level is often used as a marker to detect prostate cancer, but in fact it can be elevated by non-cancerous prostate growth. 

There is indeed an intense search to find a DNA analysis, imaging technique, or some better way of finding the life-threatening cancer.

There is no question that prostate cancer can be life-threatening — it will kill 30,000 men in the United States this year. In many cases treatment is absolutely necessary, but not always. “There are some men we detect that may not want to treat,” Carroll said.

Alan Jones understands that if there are signs his cancer starts growing he will need surgery or radiation. But for now he is at peace with his decision to just wait.
       
Robert Bazell is chief science correspondent for NBC Nightly News.