According to a new study by researchers at UCLA, most men diagnosed with low-risk prostate cancer who choose “active surveillance” rather than undergo aggressive treatment aren’t being monitored as closely as they should be. Researchers found that less than 5 percent of patients who chose to forgo aggressive treatment are receiving inadequate supervision putting them in puts them in danger of their cancer progressing or metastasizing undetected. The study, which was published in the peer-reviewed journal Cancer, included 37,687 men who were diagnosed with prostate cancer between 2004 and 2007, and followed through 2009.
Researchers discovered that of the 3,656 men diagnosed with prostate cancer who chose not to undergo aggressive treatment for the disease, only 4.5 percent of patients (166 men) were receiving proper observation. “This is really an important finding, because before patients and their doctors decide to pursue active surveillance as a management option for prostate cancer, both the physician and patient should agree on a follow-up schedule to closely monitor the cancer,” said lead researcher Dr. Karim Chamie.
“What was most surprising was that patients who underwent aggressive treatment for their prostate cancer were more likely to receive routine lab testing and visits with their doctor than those not receiving aggressive treatment. In other words, those likely cured through aggressive treatment were followed more closely than patients whose cancers were left untreated.”
“In other words, those likely cured through aggressive treatment were followed more closely than patients whose cancers were left untreated,” Chamie added.
Recommended monitoring includes prostate-specific antigen (PSA) tests, physical exams, and at least one additional prostate biopsy within two years, according to Dr. Chamie.
“Many researchers have been advocating for active surveillance for men with low-risk disease,” Chamie said. “However, this study suggests that before we advise our patients to pursue active surveillance for their prostate cancers, we should be certain that we are committed to closely monitoring the cancers with a repeat biopsy, PSA testing and physical exams.”
The study was funded by the Department of Defense and National Institutes of Health and was published in the Dec. 1 issue of the journal Cancer.