active surveillance for large numbers of prostate cancer patients

Moral of the story: With prostate screening methods being pretty crummy, people are finally starting to realize that low grade prostate cancer might be better treated (at least at first) simply with a watch and wait protocol. Biopsy and surgery have risks, which may be able to be postponed indefinitely.

Source: AMA Morning Rounds 3/29/2010

Major medical organization endorses active surveillance for large numbers of prostate cancer patients.

The Chicago Tribune (3/28, Graham) reported that "for the first time," active surveillance is "being endorsed for large numbers of men by a major medical organization: the National Comprehensive Cancer Network, an alliance of 21 leading cancer centers across the US." According to "new guidelines," the approach is recommended "for men deemed to have 'very low risk' prostate cancer and a life expectancy of less than 20 years," as well as for those men whose "prostate cancer is considered 'low risk' and" have a "life expectancy" of "less than 10 years." In other words, "almost 40 percent of the 192,000 men diagnosed with prostate cancer each year could qualify for active surveillance under those standards, said Dr. James Mohler," part of the "committee that prepared the guidelines."

        Researchers in Illinois conducting active surveillance studies. The Chicago Tribune (3/28, Graham) reported that last year, NorthShore University Health System began "recruiting men who are at least 60 years old with low-grade prostate cancer (Gleason score of 6 or less) and relatively low PSA scores (less than 10)" to find out which patients "can be managed safely with active surveillance." Adhering to "a slightly different protocol," University of Chicago researchers are also "tracking about 50 men with low-grade, low-risk prostate cancers." Meanwhile, a third trial, in which University of Toronto researchers "examined 453 men undergoing active surveillance over a period of up to 13 years," revealed that "men's risk of dying from prostate cancer during the study was one percent, while their risk of dying from another condition was 16 times as high," according to results "presented last year at meetings of the American Society of Clinical Oncology."