CANCER DIGEST – Oct. 21, 2016 – When offered the treatment option of active surveillance, the number of Swedish men with low-risk, slow growing prostate cancer who chose that option increased by one third, a new report shows. The question is, would American men make a similar choice if offered active surveillance?
Led by Stacy Loeb, MD, MSc, of the NYU Langone Medical Center, the researchers tapped into Sweden’s National Prostate Cancer Register, one of the few such national databases in the world (and for which nothing comparable exists in North America).
Published in the Journal of the American Medical Association (JAMA) Oncology online Oct. 20, the report shows that well over half of 32,518 men in Sweden diagnosed with prostate cancers least likely to spread chose monitoring during a recent, five-year period over immediate treatment.
Among the study's key findings was that from 2009 to 2014 the number of Swedish men with very low-risk cancer choosing active surveillance increased from 57 percent to 91 percent. Those men with low-risk cancer choosing this option rose from 40 percent to 74 percent. Meanwhile, the authors report, the number of men in both groups who chose to simply wait, do no further testing, and postpone therapy unless symptoms develop -- a passive practice called watchful waiting -- dropped by more than half.
Active surveillance differs from watchful waiting in that active surveillance involves ongoing monitoring with regular blood tests, physical exams and periodic biopsy. Watchful waiting involves no treatment unless cancer symptoms emerge.
A recent large study showed no difference in death rates a decade after diagnosis between those who chose active surveillance and those who chose immediate treatment, Loeb says.
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