Active monitoring for prostate cancerThere are important news. Surgery is not required for several men who have been diagnosed with prostate cancer. Active monitoring is enough. The news is contained in a study presented at the congress of the European Association of Urology underway in Milan. The results were published in the scientific journal New England Journal of Medicine.
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Active monitoring for prostate cancer: very similar survival rates
Researchers have shown that active monitoring ensures 15-year survival rates of approximately 97 percent in patients with localized prostate cancer. These are the same rates insured by surgery and radiotherapy.
Experts analyzed data from nearly 1,700 people diagnosed with localized prostate cancer. The working group divided the participants into three groups. They followed the former with active tracking. The second suffered a prostatectomy, then the removal of the gland. The third group was subjected to radiotherapy. The experts followed the participants for 15 years.
The results of the study presented in Milan
At the end of the follow-up period the researchers found a prostate cancer mortality of:
- 3.1% in the active monitoring group,
- 2.2% in those with prostatectomy,
- 2.9% with radiotherapy.
Monitoring has therefore guaranteed survival rates very similar to the other two methods, without having the side effects of surgery and radiotherapy. However, there are also disadvantages. In fact, the risk of developing metastases rises: 9.4% against 4.7% of those who had undergone surgery and 5% of those who had had radio done. The risk of clinical progression of the disease is also higher.
In addition, approximately 2 of 3 patients monitored over the 15 years still required surgery or radiation therapy.
What is active monitoring for prostate cancer?
Active surveillance is performed on mildly aggressive prostate cancer patients. The goal is to remove or at best remove more invasive therapies that are not immediately necessary. Surgery and radiotherapy have side effects, which in some cases can have important consequences on the quality of life of patients. The main ones are erectile dysfunction and urinary incontinence.
The characteristics of the patient
The patient must generally have these characteristics, even if the evaluation must be made with his own doctor, discussing the risks and benefits:
- PSA totals: must not exceed the threshold of 10ng/ml. PSA density should not exceed 0.2.
- During rectal examination, the doctor should find no palpable nodule or a small nodule.
- The percentage of tumor infiltration in a single sample must not exceed 50%.
- The Gleason score (which is obtained from the histological aspects of the tumor and is correlated with the aggressiveness of the disease) must not exceed the value of 6.