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Report suggests similar effectiveness among options for managing low-risk prostate cancer
Date:1/5/2010

A comprehensive appraisal of the management and treatment options for low-risk prostate cancer found that the rates of survival and tumor recurrence are similar among the most common treatment approaches, although costs can vary considerably. The report was prepared by the Institute for Clinical and Economic Review (ICER), a leader in comparative effectiveness research based at the Massachusetts General Hospital's Institute for Technology Assessment.

Bringing together the findings from three previous reviews completed by ICER, the final summary report, "Management Options for Low-Risk Prostate Cancer: A Report on Comparative Effectiveness and Value," compares multiple approaches to managing the most common non-skin cancer among U.S. men:

  • Active surveillance, a "watch and wait" strategy with careful monitoring and referral for surgery or radiation if necessary;
  • Radical prostatectomy, surgical removal of the prostate via traditional "open" or robot-assisted approaches;
  • Brachytherapy, implantation of radioactive seeds in the prostate;
  • Intensity-modulated radiation therapy (IMRT) and proton therapy, two forms of external radiation therapy.

The ICER review found that there are no definitive head-to-head studies comparing these options, but that accumulated evidence from multiple studies over the years suggests that overall survival and the rate of cancer recurrence are quite similar among all options, including active surveillance. There are different risks for certain side effects and complications, but no treatment option stands out as superior overall. Because low-risk prostate cancer is typically slow-growing and may not cause any symptoms, active surveillance is a reasonable option, particularly for men 65 and older, approximately half of whom will never have their cancer progress to the point of requiring treatment.

"ICER's review provides a welcome objective summary of what we know and what
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Contact: Sarah K. Emond
semond@icer‑review.org
617-724-5497
Massachusetts General Hospital
Source:Eurekalert

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