Patients choosing surveillance over aggressive treatment for prostate cancer are not being monitored as closely as they should be, according to a new study published by a team of University of California, Los Angeles (UCLA) researchers in the journal Cancer.
Many patients diagnosed with low-risk prostate cancer opt for surveillance, in which their disease is closely monitored for progression, over more aggressive treatment options such as surgery or chemotherapy, which can often have adverse side effects that effect long-term quality of life. Proper surveillance of low-risk prostate cancer includes the use of routine tests for specific prostate antigen as well as frequent office visits for physical examination. At least one additional prostate biopsy within 2 years of diagnosis is also recommended.
However, after examining the medical records of more than 37,000 patients diagnosed with prostate cancer and following these patients for 2 years after their diagnoses, researchers found that, of the 3,656 patients who decided to forego aggressive treatment, only 166 (4.5%) were being monitored appropriately.
“Many researchers have been advocating for active surveillance for men with low-risk disease,” said Karim Chamie, MD, an assistant professor of urology at UCLA and lead author of the study. “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.”
Dr. Chamie’s team noted that, as time passed, patients were more likely to adhere to better standards of surveillance. In future studies, the researchers will determine whether surveillance practices continue to improve over a longer period of time. Further research is also needed to determine the factors that drive decision-making and contribute to better surveillance in patients with prostate cancer.
