Dr. Bertrand Guillonneau and colleagues from Memorial Sloan-Kettering Cancer Center, New York, conducted a study of 268 men less than 75 years of age who had low-risk prostate cancer as defined by their levels of prostate specific antigen (PSA) and initial biopsy findings. The goal of the study was to determine whether it is safe to delay treatment and instead, to actively monitor men with early-stage prostate tumors. As Dr. Guillonneau explains, “Despite the potential survival advantages associated with prostate cancer treatment, there is still a large number of patients who are over-treated and who will suffer from prolonged side effects that impair their quality of life.”
The participants had the option of receiving multiple types of treatments, but ultimately chose “active surveillance.” A second “restaging” biopsy was performed just before active surveillance began. For the following six months they received no treatment. Physical exams and PSA tests were conducted every six months, with biopsies recommended every one to two years. Of the 268 participants, 219 were able to remain on active surveillance, with no evidence that their disease had spread. Of that original pool, the disease was shown to have progressed in 43 men, all of whom eventually chose to have either surgery or radiation treatment. And of those, all but one was cured of their disease.
Researchers concluded that active surveillance based on strict criteria, with delayed treatment only as necessary, is safe for patients with early prostate tumors – as long as the disease is monitored on a regular basis. “Our study indicates that 75 percent of the patients who are real candidates for active surveillance will still fulfill the same criteria five years later, demonstrating the absence of noticeable (disease) progression,” says Dr. Guillonneau. “It seems likely, for many of them, the prostate cancer will not ultimately develop and will not require any kind of active and therefore morbid treatment,” he adds.
News Release: “Watchful waiting” safe for some prostate cancers www.reuters.com March 31, 2009
