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'Watchful waiting' is a viable option for prostate cancer patients with low-risk tumors
Date:8/31/2009

BOSTON -- Appropriately selected prostate cancer patients, including older men and men with small, low-risk tumors, may safely defer treatment for many years with no adverse consequences, according to a new study in the Journal of Clinical Oncology (JCO). Led by researchers at Beth Israel Deaconess Medical Center (BIDMC), the study appears online today.

"With the advent of PSA [prostate antigen] screening nearly 20 years ago, we started to detect prostate cancers at much earlier stages," explains corresponding author Martin Sanda, MD, Director of the Prostate Cancer Center at BIDMC and Associate Professor of Surgery at Harvard Medical School.

"Consequently, while PSA testing has enabled us to successfully begin aggressive treatment of high-risk cancers at an earlier stage, it has also resulted in the diagnosis of cancers that are so small they pose no near-term danger and possibly no long-term danger," he adds.

Sanda, together with coauthors from Brigham and Women's Hospital, the Harvard School of Public Health and the University of California, San Francisco, looked at the Health Professionals Follow-Up Study, a large cohort study comprising 51,529 men who have been followed since 1986. Every two years, the participants respond to questionnaires inquiring about diseases and health-related topics, including whether they have been diagnosed with prostate cancer.

A total of 3,331 men reported receiving a diagnosis of prostate cancer between 1986 and 2007. Further analysis found that among this sub-group, 342 men just over 10 percent had opted to defer treatment for one year or longer. Ten to 15 years later, half of the men who had initially deferred treatment still had not undergone any treatment for prostate cancer.

"We wanted to find out how this group of men fared in the long-term," explains Sanda. "So we looked at the data they provided us at an average of eight years after their initial diagnosis, and
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Contact: Bonnie Prescott
bprescot@bidmc.harvard.edu
617-667-7306
Beth Israel Deaconess Medical Center
Source:Eurekalert

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