Active surveillance is becoming a widely accepted option for some men with prostate cancer. Instead of immediate treatment, men on lively surveillance are monitored periodically with biopsies, physical examinations of the prostate, and prostate-specific antigen (PSA) tests. Treatment begins when the cancer shows signs of growth.
But is it protected to attend until then? Oh A new study adds to growing evidence that the reply is yes, but just for men whose cancers fall into favorable risk categories.
The study is predicated on data collected at Johns Hopkins Hospital in Baltimore, Maryland, site of a long-running lively surveillance program. The authors studied nearly 1,300 men who were enrolled in lively surveillance between 1995 and 2014. Most of the lads had “very low-risk cancer,” meaning their PSA levels weren’t very high on the time of diagnosis and that only a small amount of cancer was present. Grade cancer was present in as many as 2 cores of an ordinary 12-core biopsy. The rest were within the “low-risk” category, meaning low-grade cancer detected in not more than 5 cores.
The average age of the lads at diagnosis was 66 years. By the time the evaluation ended, 49 men had died, but only 2 of them from prostate cancer. Cancer-specific survival rates within the very low-risk and low-risk categories exceeded 99 percent at each 10 and 15 years of follow-up, and heart problems was by far the leading reason for death.
“These findings confirm that men with favorable-risk cancers should be encouraged to consider active surveillance rather than treatment because they are less likely to be harmed by a diagnosis,” said Dr. Jonathan I. Epstein, Pathology. , Professor of Urology, and Oncology. Johns Hopkins Hospital who led the study.
It is essential to notice that prostate cancer can worsen on lively surveillance. During the study, 22 percent of very low-risk men and 31 percent of low-risk men ultimately required treatment inside 15 years. But by the point treatment was initiated, men had been on lively surveillance for a median of 8.5 years.
“Very low-risk men clearly make excellent candidates for active surveillance,” Epstein said. “But in the case of low- and even intermediate-risk cancers, advanced age and other health problems may increase eligibility.”
Epstein added that some men may feel strongly that they don't need to live with cancer, which can cause them to opt out of lively surveillance in favor of treatment. “We are trying to develop strategies to help these people,” he said.