Navigation Links
'Watchful waiting' is a viable option for prostate cancer patients with low-risk tumors

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 compared it with data provided by prostate-cancer patients who had opted for aggressive treatment, such as surgery, radiotherapy or hormonal therapy.

"We found that the deaths attributed to prostate cancer were very low among the men with low-risk tumors," explains Sanda. "Our analysis showed that only two percent of the men who deferred treatment eventually died of the disease, compared with one percent of the men who began treatment immediately following their diagnosis. This is not a statistically significant difference."

There are three types of prostate cancer: High risk, which are large, faster-growing cancers; intermediate risk; and low-risk, which are small and slower growing cancers. While there is ample evidence that treating intermediate and high-risk cancers with either surgery, radiation or hormone therapy can save lives, whether and how best to care for low-risk cancers remains uncertain.

"These findings showed that men diagnosed with low-risk tumors who deferred treatment were still doing fine an average of eight years -- and up to 20 years -- following their diagnosis.

"Only half of these men wound up undergoing any treatment 10 to 15 years post-diagnosis," says Sanda. "This means that they were able to avoid the disruption in their quality of life which might have occurred had they undergone immediate treatment.

"If this approach was more broadly accepted as a standard care option for suitable low-risk prostate cancers, it might help us avoid throwing the baby out with the bathwater when it comes to the PSA test," he adds. "Instead of just abandoning the PSA test because it might be leading to an overdiagnosis of prostate cancer, we could conduct PSA screening in a way that allows more aggressive prostate cancers to be treated, while less aggressive tumors could initially be monitored. This would avoid problems due to treatment of 'overdiagnosed' low-risk cancers, while preserving the lifesaving benefits of treating aggressive cancers that have been detected through PSA testing."


Contact: Bonnie Prescott
Beth Israel Deaconess Medical Center

Related medicine news :

1. Radiation seed implant decreases risk of death over watchful waiting
2. Keep a Watchful Eye on Sugary Beverage Consumption
3. Watchful Waiting Safe With Low-Risk Prostate Cancers
4. SPCG-4 trial: Update on watchful waiting versus radical prostatectomy
5. Microtek Medical Receives Early Termination of Hart-Scott-Rodino Act Waiting Period for Its Proposed Acquisition by Ecolab
6. Siemens Announces Early Termination of Hart-Scott-Rodino Waiting Period For Acquisition of Dade Behring Holdings, Inc.; U.S. Antitrust Clearance Achieved
7. New Technology at Unitrin Direct Gives Customers an Alternative to Waiting
8. New Heart Pump Helps Women Awaiting Transplants
9. Governor Rendell Offers Coverage to 29,000 on AdultBasic Waiting List; Unveils New Policy to Improve Quality of Care for the Low-Income and Pennsylvanians With Disabilities
10. Blacks awaiting lung transplants more likely to die or be denied than whites
11. Blacks Awaiting Lung Transplants Face Poorer Outcomes
Post Your Comments:
(Date:6/25/2016)... ... June 25, 2016 , ... ... issues and applications at AcademyHealth’s Annual Research Meeting June 26-28, 2016, at the ... several important health care topics including advance care planning, healthcare costs and patient ...
(Date:6/25/2016)... ... , ... First Choice Emergency Room , the largest network of independent ... Director of its new Mesquite-Samuell Farm facility. , “We are pleased to announce ... Dr. James M. Muzzarelli, Executive Medical Director of First Choice Emergency Room. , ...
(Date:6/25/2016)... ... June 25, 2016 , ... Conventional wisdom preaches the benefits ... terms of the latter, setting the bar too high can result in disappointment, perhaps ... slow progress toward their goal. , Research from reveals that ...
(Date:6/24/2016)... ... 24, 2016 , ... Marcy was in a crisis. Her son James, eight, was out of ... verbally and physically. , “When something upset him, he couldn’t control his emotions,” remembers Marcy. ... throw rocks at my other children and say he was going to kill them. ...
(Date:6/24/2016)... Diego, CA (PRWEB) , ... June 24, 2016 , ... ... with the American Cancer Society and the Road To Recovery® program to drive cancer ... to seniors and other adults to ensure the highest quality of life and ongoing ...
Breaking Medicine News(10 mins):
(Date:6/23/2016)... -- In a startling report released today, National Safety Council ... comprehensive, proven plan to eliminate prescription opioid overdoses. Prescription ... are tackling the worst drug crisis in recorded U.S. history, assigned ... Kentucky , New Mexico , ... 28 failing states, three – Michigan , ...
(Date:6/23/2016)... , June 23, 2016 Research ... Pharma News Issue 52" report to their offering. ... in influenza treatment creates a favourable commercial environment for MedImmune ... growing patient base that will serve to drive considerable growth ... vaccine would serve to cap sales considerably, but development is ...
(Date:6/23/2016)... and BOGOTA, Colombia , June 23, 2016  Astellas today announced the establishment of Astellas ... Brasil as the company,s second affiliate in Latin America . ... ... of Astellas Farma Colombia ... ...
Breaking Medicine Technology: