New research suggests men who have relatively unaggressive prostate tumors that are closely monitored have a very low risk of metastasis or death from their disease.
A survival study that monitored patients for about 15 years revealed only two out of 1,298 men who were being actively monitored died of prostate cancer, and three experienced metastasis, the Johns Hopkins University School of Medicine reported. The researchers calculated that from these results, men in the program were 24 times more likely to die from a cause than the prostate cancer itself.
"Our study should reassure men that carefully selected patients enrolled in active surveillance programs for their low-risk prostate cancers are not likely to be harmed by their disease," said H. Ballentine Carter, the Bernard L. Schwartz distinguished professor of urologic oncology and director of adult urology.
Only about 30 to 40 percent of U.S. men with prostate cancer opt for active surveillance, compared to about 80 percent in Scandinavian countries. Choosing active surveillance could significantly reduce one's side effects and cost of treatment. A recent report showed 20 percent of patients undergoing radiation or surgery for prostate cancer were readmitted to the hospital within five years for a treatment-related complication.
The researchers noted the results may be slightly skewed because of the fact that doctors often carefully select the best candidates for active surveillance. They also note that most men involved in the study were Caucasian, and the results may differ for other demographics.
"Our goal is to avoid treating men who don't need surgery or radiation. The ability to identify men with the most indolent cancers for whom surveillance is safe is likely to improve with better imaging techniques and biomarkers," Carter concluded.
The findings were published in a recent edition of the Journal of Clinical Oncology.
