One in every six men will get a prostate cancer diagnosis at some point in his lifetime – an estimated 219,000 new diagnoses in 2007. When their urologist gives men the bad news, many face a difficult, binary, and potentially life-altering decision. Should they have the prostate surgically removed or just wait and see how the cancer grows? Neither choice is easy to make. On one hand, admits William Huang, MD, a urological oncologist at New York University's Langone Medical Center, "The treatment can be worse for the person's quality of life than the cancer itself." In support of the latter choice, in some cases the cancerous lesions are so small and grow so slowly that they will most likely never develop into clinically detectable disease or have any detrimental impact on a man's health or longevity. But physicians can't predict from present forms of testing whether a tumor will grow quickly or slowly, whether the cancer will metastasize or not. Left untreated, the disease can kill: More than 27,000 men died of metastatic prostate cancer in 2007.
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