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Prostate Cancer Patients Choosing Surveillance Don’t Follow Recommendations

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The majority of men with prostate cancer who choose to forgo aggressive therapies and undergo “active surveillance”, do not follow the recommendations for follow-up visits and testing. These results were recently published in the journal, Cancer.

Prostate cancer is the most common type of cancer diagnosed in males in the United States, besides skin cancer. Men with early and non-aggressive prostate cancers (low-grade) have the option of monitoring their disease, and forgoing treatment until their cancer progresses. This allows patients whose cancers do not pose an immediate health threat and/or do not reduce their quality of life to postpone treatment and its associated side effects.

The recommendations set forth by physicians to monitor cancer progression, however, appear to be inadequately adhered to by patients choosing this therapeutic option. Monitoring includes laboratory testing for prostate-specific antigen (PSA) levels, physical examinations, and at least one additional prostate biopsy within a two-year period.

Researchers from UCLA conducted a study to determine the rate of men who adhered to the recommended follow-up monitoring appropriate for active surveillance. The study included data from 37,687 men diagnosed with prostate cancer between 2004-2007.

Of the men diagnosed with low-grade prostate cancer who chose to undergo active surveillance, only 4.5% adhered to the recommended monitoring schedule.
Men diagnosed with more aggressive prostate cancer who chose aggressive treatment had much higher compliance rates for follow-up visits and testing than those who chose active surveillance.
Men with low-grade prostate cancer who choose active surveillance should speak with their healthcare provider regarding their follow-up schedule for monitoring their disease.

Reference: Chamie K, Williams S, Hershman D, et al. Population-based assessment of determining predictors for quality of prostate cancer surveillance. Cancer. 2015; 121(23):4150-4157.