Active surveillance helps men avoid effects of prostate cancer treatment

Active surveillance helps men avoid effects of prostate cancer treatment

Men with prostate cancer could dispense with radiation treatment and surgery, and avoid the negative effects that go along with it, including incontinence and impotence, by undergoing active surveillance.

The finding, published in the journal European Urology, came from a study at Sahlgrenska Academy, University of Gothenburg, Sweden that analyzed about 1,000 men diagnosed with prostate cancer.

Screening for prostate cancer, with prostate specific antigen (PSA) tests, can detect tumors early, therefore decreasing the number of death rates. A report from the The Journal of Urology revealed that PSA testing increased rates of survival for patients whose disease has metastasized to other parts of the body.

However, this type of cancer usually grows slowly and several men never even develop any symptoms. This means that they are receiving unnecessary treatment and have to suffer the severe reactions from it, including urinary incontinence, impotence, and bowel disorders.

After examining 968 men, the team discovered that many prostate cancer victims could dispense with treatment and not have to suffer the awful side-effects if they undergo active surveillance. This study is part of a larger one that has been in progress in Gothenburg since 1995 under the direction of Jonas Hugosson of Sahlgrenska Academy, University of Gothenburg.

Rebecka Arnsrud Godtman, a doctoral student supervised by Jonas Hugosson, explained:

"Active surveillance means monitoring development of the tumor through regular PSA-tests and prostate biopsies. If the tumor shows signs of growth or becomes more aggressive, then the next stage is surgery or radiation treatment. Many men can entirely avoid or at any event postpone the adverse effects associated with curative treatment."

About half (46%) of the men agreed to use active surveillance as the treatment strategy. Most of the patients had low-risk tumors, but there were some men with intermediate or high-risk tumors.

The results revealed that:

  • 60 of the 440 subjects who underwent active surveillance died, but only 1 death was caused by the cancer
  • 63% of the men analyzed kept using active surveillance for the rest of the follow-up period (up to 15 years)
  • 37% did not want to continue with active surveillance because they wanted treatment (radiation treatment, surgery, or hormone therapy), mainly because the tumor had grown
  • None of the low-risk tumor patients developed metastatic prostate cancer or died from the disease
  • 4 wished to stop the surveillance because it made them feel anxious
For males with intermediate or high-risk tumors, active surveillance is more dangerous. The risk of these men developing terminal and/or incurable cancer was four times higher compared to those with low-risk tumors.

Godtman concluded:

"Overall, our results show that active surveillance has the potential to reduce overtreatment, enabling more men to avoid side-effects. A large proportion of the tumours detected through PSA screening are low-risk tumours, and older men in particular could dispense with treatment and instead be monitored safely with active surveillance."

Men Can Avoid Prostate Cancer Treatment Effects with Active Surveillance (Video Medical And Professional 2020).

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