Prostate Cancer: No Treatment OK for Some
Outcomes Good With Active Surveillance, New Study Suggests
WebMD News Archive
Prostate Cancer Without Treatment continued...
All the men were younger than 75 at recruitment, with the average age being
64. All had early-stage, localized disease and all had the most favorable
biological disease markers, including a prostate-specific antigen (PSA) score
of below 10 ng/mL and a Gleason score of 6 or below.
Instead of having one biopsy to determine eligibility for active
surveillance, the patients had two. The second biopsy was done between 3.7-10.5
months after the first biopsy. As a result of the second biopsy, about 30% of
the patients who were initially considered candidates for surveillance were
excluded from the study because they ended up undergoing treatment.
“We feel that the second biopsy was an important step in identifying
patients who are not good candidates for active surveillance,” Eggener
Most Patients Did Not Progress
With active surveillance, the patients had physical exams and PSA tests
every six months, with biopsies recommended every one to two years.
Over an average of two and a half years of follow-up, 43 of the study
participants showed evidence of cancer progression and received treatment.
In two patients, cancer spread beyond their prostate.
The study is published in the April issue of the Journal of
The findings support the idea that some men with prostate cancer may not
need treatment, American Cancer Society Deputy Chief Medical Officer Len
Lichtenfeld, MD, tells WebMD.
He says the addition of a second biopsy should help refine the search for
men who are appropriate candidates for active surveillance, but he also agrees
that the strategy of watchful waiting is not without its risks.
“The real advance will be when we have tests that will tell us with a high
degree of accuracy when treatment is needed and when it is not,” he says.
A great deal of research is being done to identify genetic tests or tumor
markers that can do this, but Lichtenfeld says it will be years before these
tests are validated.