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Don't cure prostate cancer

It's true to say that most men die with prostate cancer rather than from it. It's now the most prevalent cancer in men, having overtaken lung cancer, but it's also one of the most benign.

Sadly the same cannot be said for the remedy. Radical interventions such as surgery and radiotherapy can cause permanent incontinence and impotence in around a quarter of all patients.

Doctors never seem to get around to telling the patient about these risks, nor do they put forward gentler approaches that may at least make life worth living.

The other essential part of the treatment choice should be determined by the age of the patient. Not only is prostate cancer a relatively benign cancer, it also tends to be a slow-acting one as well. So the treatment may be different for a man in his fifties compared with one in his seventies. In the latter case, a 'watchful waiting' approach is by far the kindest.

Finally this is being taken up by the Institute for Cancer Research in the UK. They've finally put their collective heads above the parapet and pronounced that the treatment may be worse than the disease.

They point the finger at the standard PSA test for detecting prostate cancer, which is not the most reliable of tests. But, worse still, it cannot detect aggressive cancers from the slower-acting ones, which the Institute helpfully dubs in user-friendly speak 'tigers' and 'pussycats'.

The Institute reckons that up to half of all men diagnosed with prostate cancer do not need any treatment at all. As Chris Parker at the Royal Marsden Hospital succinctly put it: "Prostate cancer is the only human cancer that is curable but which commonly does not need to be cured."