It’s hard to believe that Sir Ian McKellen, the 80-year-old British actor best known for his iconic performance playing the heroic wizard Gandalf the Grey in the “Lord of the Rings” trilogy, has been living with cancer since 2006. McKellen’s career has never once wavered in the 13 years since his prostate cancer diagnosis; he’s starred in three “Hobbit” movies along with several other films and plays, and now this month he is debuting “Ian McKellen on stage.” The show will debut in London and consist of McKellen recreating roles from MacBeth to Gandalf.
And yet, in 2012, McKellen revealed to a number of British newspapers that he was not treating his prostate cancer — opting instead for the “watch and wait” approach.
RELATED: The Benefits of Active Surveillance
When Is Active Surveillance a Good Idea?
Dr. James Brooks, a surgical oncologist at Stanford Medicine, previously explained to SurvivorNet that active surveillance — or monitoring — is a good idea for men “who have a localized, low-risk or very low-risk prostate cancer.”
Dr. Brooks went on to explain that “low-risk” means that very small amounts of cancerous cells show up on a biopsy, and the prostate-specific antigen (PSA) identified in blood tests is fairly low. By “localized,” Dr. Brooks explained that he meant a prostate cancer that was confined to the prostate and had not spread widely throughout the body.
The reason that doctors often recommend an active surveillance approach in these low-risk prostate cancers is that moving forward with aggressive treatment might cause more harm than the cancer itself — which could very well grow slowly enough that the patient survives many years and ultimately dies of unrelated causes. Treatments such as radiation or surgery, on the other hand, have the potential to damage a man’s sexual quality of life or cause lifelong urination trouble.
“One of the major challenges of prostate cancer is finding out who needs treatment and who does not,” Stanford Medicine’s Dr. Geoffrey Sonn also told SurvivorNet, adding that almost all men will have prostate cancer at some point in their lives.
“If we live long enough, most men, the majority of men, will have prostate cancer, but only a small fraction will die of prostate cancer,” Dr. Sonn said. “However, because prostate cancer is so common, almost 3% of all men will die of prostate cancer. And our challenge is to figure out which men are at risk of dying of prostate cancer and treat them, while not treating those who may have a type of prostate cancer that in many cases can sit in the prostate and not cause any problems or symptoms during the course of that man’s lifetime.”
RELATED: Active Surveillance Works Well But Only in Certain Cases
After the results of blood tests and imaging tests are available, this decision is usually made by both the patient and the doctor together.
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