"Theres too little evidence to say definitively whether treating early localized prostate cancer with radiation is a better option than watchful waiting new research finds. In a study funded by the Agency for Healthcare Research and Quality AHRQ researchers from Tufts University reviewed the available literature on radiation and prostate cancer including  randomized controlled trials and  observational studies. They concluded there was insufficient evidence to say with certainty whether radiation treatment compared to watchful waiting is more likely to save lives. We just dont have sufficient information to say much of anything said Dr. Stanley Ip an assistant professor of medicine at Tufts University Medical Center. In part thats because researchers found no randomized controlled trials  considered the gold standard of research  that compared radiation therapy with watching waiting Ip said. Though there were observational studies those may be biased because men who opt to hold off on treatment may be those whose tumors are lower risk to begin with he said. The study is published in the June  issue of the Annals of Internal Medicine. Watchful waiting  which does not involve cancer treatment  means having regular exams while keeping an eye on the tumor to see if it grows or spreads. It is usually recommended when doctors feel someones advanced age will allow them to outlive the generally slowmoving cancer or when someone has other conditions that are more likely to prove lethal. Men who are diagnosed with early prostate cancer  meaning its confined to the prostate gland and has not spread  are confronted with a bewildering array of options for treating it surgery radiation drugs to deprive the tumor of the hormone androgen that may drive its growth or watchful waiting. In  AHRQ also commissioned a review of studies on other prostate cancer treatment options but that report could not draw conclusions on the best approach either. What all of these analyses have found is there is very limited data that allows us to determine which of these approaches in the best approach said Dr. Durado Brooks director of prostate cancer for the American Cancer Society.  Brooks said more comparative effectiveness research which compares different kinds of treatments is needed. In the meantime what are men diagnosed with early prostate cancer to do Men and their doctors need to consider what the tumor looks like under the microscope which can help gauge how aggressive it may be. They should also consider age and overall health status including whether or not the patient has other conditions more likely to cause death than the prostate cancer. Finally patients and their doctors should weight the potential debilitating side effects of the treatments such as incontinence and erectile dysfunction against how comfortable the man is with holding off on treatment experts say. Men need to learn as much as they can about the possible outcomes and benefits of the various treatments and the potential side effects and choose which direction they are most comfortable with Brooks said. In the current review researchers found several trials that compared different doses of radiation and different types of radiation therapy including external beam radiation therapy in which a radiation is delivered through a beam through the skin or brachytherapy in which radioactive isotopes are delivered via injection into the prostate. For those methods too there was too little research to say with confidence which method was superior in preventing deaths from prostate cancer the researchers said. Retrospective studies however found that radiation treatments were associated with increased urinary or bowel problems compared with no treatment or no initial treatment. There was also moderate strength evidence that a higher external beam radiation was more effective than a lower dose. Taken together the review does point out that based on current evidence doctors should not be telling their patients that this form of radiation is better than that form Brooks said. Some of the distinctions being made are not really supported by the evidence. Proton beam therapy in particular is expensive but according to this report there isnt enough evidence to show its any better than other option. Radiation he noted may be the best option for men whose tumors have spread outside the gland since simply removing the prostate gland surgically is not likely to be as effective he said. The American Cancer Society estimates that in  approximately  men were diagnosed with prostate cancer and approximately  men died of the disease. More information The National Cancer Institute http has more on prostate cancer. SOURCES Stanley Ip M.D. assistant professor medicine Tufts University Medical Center Boston Durado Brooks M.D. director prostate cancer American Cancer Society Atlanta June   Annals of Internal Medicine"