Navigation Links
Delay in surgery not likely to worsen tumors in men with low-risk prostate cancer

Johns Hopkins experts have found that men enrolled in an active surveillance program for prostate cancer that eventually needed surgery to remove their prostates fared just as well as men who opted to remove the gland immediately, except if a follow-up biopsy during surveillance showed high-grade cancer.

Active surveillance, or "watchful waiting," is an option open to men whose tumors are considered small, low-grade and at low risk of being lethal. Given the potential complications of prostate surgery and likelihood that certain low-risk tumors do not require treatment, some men opt to enroll in active surveillance programs to monitor PSA levels and receive annual biopsies to detect cellular changes that signal a higher grade, more aggressive cancer for which treatment is recommended. Yet, according to the Johns Hopkins experts, there is concern that delaying surgery in this group until biopsy results worsen may result in cancers that are more lethal and difficult to cure.

Bruce Trock, Ph.D., associate professor at the Johns Hopkins Brady Urological Institute, and his colleagues compared the pathology results of men in an active surveillance group at Johns Hopkins who later had surgery with those who also had low-risk tumors and opted for immediate surgery.

Results initially showed that 116 active surveillance participants who had surgery were more likely to have high-grade, larger tumors than 348 men who had immediate surgery. But Trock says that these results were found only in 43 (37 percent) men in the surveillance group who were recommended for surgery because a follow-up biopsy during surveillance worsened to indicate a high-grade tumor.

"We think that these men had high-grade tumors to begin with that their initial biopsy missed, and this group may be over-represented in men who are recommended for treatment after an initial period of active surveillance," says Trock. He adds that, in general, 15 to 25 percent of men whose initial biopsy shows a low-risk prostate tumor will actually have a high-grade cancer upon further review of the entire prostate once it is removed.

Apart from the 43 men whose pathology results worsened during surveillance, the remaining men in the surveillance group had similar pathology results at surgery to those in the immediate surgery group. "This means that most tumors are not likely to worsen during the period of active surveillance," says Trock.

The researchers calculate that the risk of finding high-grade tumors in the entire group of 801 active surveillance patients is low -- about 4.5 percent per year.


Contact: Vanessa Wasta
Johns Hopkins Medical Institutions

Related medicine news :

1. No Benefit Seen in Delaying Infant Vaccinations
2. $18.5 Million New Jersey Medical Malpractice Birth Injury Verdict Due To Cerebral Palsy Caused By A Delayed C-Section
3. Lower wages, lack of job opportunities means more Americans delaying adulthood
4. Brain Area That May Delay Need for Gratification Found
5. Money Worries Delay Heart Attack Treatment
6. Targeting the blood-brain barrier may delay progression of Alzheimers disease
7. Delayed retirement among Americans may bolster future of Social Security and Medicare, study finds
8. In brain-injured children, early gesturing predicts language delays
9. Pain Relief Often Delayed for Cancer Patients
10. Green Tea Extract May Delay or Prevent Alzheimers
11. Delaying post-surgical radiation increases risk of breast cancer recurrence in older women
Post Your Comments:
(Date:10/13/2015)... ... October 13, 2015 , ... “Women have 2 questions when they ... to live?’ The second is, “Will I lose my hair?’” , Carly Klein is ... women with licensed medical professionals to develop personalized hair loss treatment plans. With 10 ...
(Date:10/13/2015)... — , ... ... Association of America (MOAA) will hold its 2015 annual meeting ... a free military career fair; informational seminars; a luncheon featuring ... the Joint Chiefs of Staff; and the Community Heroes Award ...
(Date:10/13/2015)... ... ... The American Institutes for Research ( AIR ) developed a collection of guides ... sexual assault and other trauma. The toolkit, funded by the U.S. Department of Education, ... 21st anniversary. , AIR developed the Safe Place toolkit in ...
(Date:10/13/2015)... ... 13, 2015 , ... "My friend's son suffers from eczema, and he had ... an inventor from Platteville, Colo. "I came up with this kit as a way ... to prevent a child from rubbing or scratching his or her face. This protects ...
(Date:10/13/2015)... , ... October 13, 2015 , ... According to an ... recent study has shown that women who successfully lose weight with a bariatric procedure ... United States each year. The article notes that anywhere from 40 to 50 percent ...
Breaking Medicine News(10 mins):
(Date:10/13/2015)... , Oct. 13, 2015   Vigilant Biosciences, ... solutions that aid in the early detection and intervention ... awarded Vigilant,s founder and CEO, Matthew H.J. Kim ... Award, which recognizes an entrepreneur who has made extraordinary ... life sciences industry in the leadership of a ...
(Date:10/13/2015)... , Oct. 13, 2015   ... first-ever direct-to-consumer laboratory home testing kit for ... digital technologies provide an unparalleled, detailed assessment ... breast milk—fats, proteins, carbs and key vitamins—all ... portal for personal health tracking.  In addition, Happy ...
(Date:10/13/2015)... , October 13, 2015 ... announced the appointment of Harry Lander , PhD as ... Company,s Chairman & CEO David Koos as Regen ... molecule and immuno-oncological therapeutics. --> Regen BioPharma, ... appointment of Harry Lander , PhD as its new ...
Breaking Medicine Technology: