IT was, many physicians would say, the right thing for a man of 53 to do. So Larry Cano had a prostate-specific antigen, or PSA, test. "It was 5.3," says Cano, a film producer from Newport Beach. "They say anything over 4 is noteworthy."
The noteworthy result, followed by a positive biopsy, sent Cano pinballing from surgeon to radiologist and back with what he believes, three years later, was an exaggerated sense of urgency.
He may have been right. Researchers -- and a few doctors -- are beginning to agree: Even many younger men with prostate cancer can afford to wait.
"Most of the time, I tell men that they may need treatment, but they're not going to die," says Mark Scholz, a Marina del Rey oncologist, specializing in prostate cancer. "A lot of men with low-grade cancer may not need treatment for five to 10 years."
Some may never need it.
No one initially told Cano that his prostate cancer was not an emergency, that he had time to talk to men who had been through the same diagnosis, to do his own research, to take a deep breath and think about how he wanted to live the rest of his life. No one told him that he could leave his prostate intact, right where it was, while carefully monitoring his condition -- and that he might be able to do that for quite a long time. Maybe forever.
Cano didn't fit the profile of the traditional candidate for what's called watchful waiting, an option that has become synonymous with doing nothing. That approach has been recommended for older men or those threatened by other diseases.
Men like him -- younger, healthier men diagnosed with earlier stages of cancer -- are typically urged to act quickly. They represent the changing demographic of the disease and, like Cano, often feel lucky to catch it early. Cano even made an appointment for surgery. "I thought, just buck up and get it done," he says.
But then he took some time to think again. He did a lot of reading, weighed risks and benefits, and ultimately decided on a form of waiting that is anything but passive.
What Cano chose represents the newest thinking in the disease, and the approach is so different from watchful waiting that no one calls it that any more. They call it active surveillance.
Three years later, his prostate is still where nature put it, he feels fine, and he has become a diligent student of his medically relevant numbers. So far, his cancer is not progressing.
