A recent study showed that active surveillance of intermediate-risk prostate cancer is associated with decreased survival. The outcomes will be presented at the 2015 Genitourinary Cancers Symposium in Orlando.
Data relative to patients suffering with prostate cancer and managed using different approaches was analyzed. Results showed that those managed with active surveillance had disease outcomes proportional to an associated low or intermediate risk at the time of diagnosis. Comparing to those with low-risk prostate cancer, patients with intermediate-risk cancer had an increased chance of dying due to the disease in a period of 15 years.
The active surveillance method highlighted in this study is a globally recognized method for those suffering with low-risk prostate cancer along with some intermediate-risk patients. Cancer Care Ontario recently presented some guidelines recommending active surveillance as a more appropriate approach for low-risk patients. Patients under active surveillance undergo PSA measurements, physical examinations, digital rectal tests and several tumor biopsies.
This was the first study that analyzed the long-term results of active surveillance in patients suffering with low and intermediate risk prostate cancer. Scientists analyzed data in a total of 945 patients under active surveillance at the Sunnybrook Health Sciences Centre. Treatment was offered to those whose disease got worse, with 86 patients from the intermediate risk group receiving treatment. Men diagnosed with intermediate-risk disease had a 3.75 times higher chance of dying due to prostate cancer when compared to patients with low-risk disease. The 10-year overall survival rate was 68.4 and the 15-year overall survival rate was 50.3 percent for intermediate-risk patients compared to 83.6 percent and 68.8 percent for low-risk patients.
“For low-risk patients with prostate cancer managed with active surveillance, the risk of dying of prostate cancer is low, validating this approach for this group of patients. More research, however, is needed to better characterize those intermediate-risk patients who can safely be monitored on a surveillance program,” explained Dr. Andrew Loblaw, a radiation oncologist at the Sunnybrook Health Sciences Centre, Toronto.
This research project was funded by the Prostate Cancer Research Foundation (now Prostate Cancer Canada) and through internal funding available from the Sunnybrook Health Sciences Centre.