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Closely monitoring low-risk prostate cancer, with biopsy, does not raise risk of death
Date:4/12/2011

A Johns Hopkins study of 769 men from across the United States recently diagnosed with low-grade prostate cancer shows that forgoing immediate surgery to remove the tumor or radiation poses no added risk of death. Delaying treatment is fine, the results show, so long as the cancer's progression and tumor growth are closely monitored through "active surveillance" and there is no dramatic worsening of the disease over time.

None of the men, mostly 65 and older, have so far died from prostate cancer since the study began in 1995. However, one-third of study participants, monitored for as long as 15 years, eventually underwent treatment, primarily because annual biopsy results showed more cancer.

The study, to be published in the Journal of Clinical Oncology and posted online ahead of print, is believed to be the largest and longest study of men initially diagnosed with a slow-growing, very nonaggressive form of prostate cancer. This means they stand very little chance of dying from the disease, which was classified as very low risk, in its earliest stage, called T1c.

"This study offers the most conclusive evidence to date that active surveillance may be the preferred option for the vast majority of older men diagnosed with a very low-grade or small-volume form of prostate cancer," says study senior investigator and urologist H. Ballentine Carter, M.D. "These are men with a favorable risk disease profile to begin with."

Carter, director of adult urology at The Johns Hopkins Hospital and a professor at the Johns Hopkins University School of Medicine and its Brady Urological Institute, acknowledges that "for some of these men, the prospect of living with prostate cancer is unbearable, and the tumor has to go." But, he adds, "the vast majority of these men are ideal candidates for active surveillance because they are older and are able to avoid the risks and complications associated with surgery and radiation." The b
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Contact: David March
dmarch1@jhmi.edu
410-955-1534
Johns Hopkins Medical Institutions
Source:Eurekalert

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