‘Active Surveillance’ of Lower Risk Prostate Cancers Seen as Safe Approach in Study, But Only in Certain Patients

‘Active Surveillance’ of Lower Risk Prostate Cancers Seen as Safe Approach in Study, But Only in Certain Patients
Researchers analyzing clinical and pathological outcomes in men with low- and intermediate-risk prostate cancer under "active surveillance" found that — despite close monitoring —   metastatic disease develops in about 3 percent of these patients, and can rise to as high as 10 percent in those at the upper limits of intermediate risk. The study, “Metastatic Prostate Cancer in Men Initially Treated with Active Surveillance,” was published in The Journal of Urology, with data also presented at the 2015 Annual Meeting of American Urological Association in New Orleans. Prostate specific antigen (PSA) testing has improved early diagnosis of prostate cancer. About 40 percent of new cases are determined to be lower-risk cancers, defined by a Gleason score (GS) of 6 or less with PSA levels of 10 ng/ml or less. Because prostate cancer treatment often includes radical therapies, such as surgery and radiation, active surveillance has been increasingly accepted as an effective approach in men with clinically insignificant disease and lower risk of cancer spread, so as to minimize aggressive treatments and their side effects. However, a small subset of patients are known to progress to metastatic disease. Researchers, from Sunnybrook Health Sciences Centre at the University of Toronto, initiated an analysis in 1995 to understand how active surveillance correlates with pathological outcomes, assessing metastasis risk. The study included 980 patients, of whom 211 (21.5%) were classified as intermediate risk, 109 (11.1%) had baseline PSA values greater than 10 ng/ml, and 133 (13.6%)
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