Urologists recommend AS more often than rad/oncs (but probably not enough)

A new article on the Medscape web site, based on an article by Kim et al. in the journal Medical Care, deals with urologists’ and radiation oncologists’ recommendations for active surveillance (AS) as an appropriate form of treatment for low-risk prostate cancer in the USA today. … READ MORE …

How to mislead the public: a case study in apparent naivety

An article in today’s Daily Telegraph in the UK starts with the misleading statement that, “Up to half of men diagnosed with prostate cancer are being given ‘false hope’ by tests that are underestimating the severity of their disease, according to the authors of a new study.” … READ MORE …

Criteria for active surveillance are gradually improving

Being diagnosed with low-risk prostate cancer is a good reason to consider management under active surveillance (as opposed to immediate, early intervention) … but active surveillance won’t be right for every low-risk patient! … READ MORE …

Medium-term follow-up of > 450 men on active surveillance in UK study

A large, single-institution study of active surveillance in England, just reported European Urology,  has again demonstrated the potential value of active surveillance in the management of low-risk prostate cancer. … READ MORE …

Eligibility criteria for active surveillance among men with low-risk prostate cancer

As regular readers of this blog will be aware, the urology group at Johns Hopkins in Baltimore has, for the past several years, had one of the most restrictive sets of criteria for eligibility for active surveillance as an appropriate method for the management of men initially diagnosed with low- and very low-risk prostate cancer. … READ MORE …

Risk for prostate cancer grade “progression” (from Gleason 6 to Gleason 7 or higher)

We know that men initially diagnosed with Gleason 6 disease can (relatively frequently) be re-diagnosed later on with Gleason 7 disease or a higher Gleason score if they are on active surveillance protocols — although we often don’t know why this happens. … READ MORE …

The role of MRI scanning prior to prostate biopsies

A pair of articles currently scheduled for publication in the December issue of the Journal of Urology has just appeared on line under the title “MRI before prostate biopsy — yes or no?” Unfortunately for our readers, access to this pair of articles is limited to subscribers to the journal (unless you want to pay), and there is no abstract. So we will try to summarize the key points. … READ MORE …

Klotz, Epstein criteria for active surveillance and actual surgical outcomes

There is no broad agreement agreement (yet) across the prostate cancer community about acceptable “standard” criteria for eligibility for active surveillance as a form of first-line management of low-risk prostate cancer. On the other hand, there are two well-characterized and relatively broadly applied sets of criteria: … READ MORE …

The pros and cons of active surveillance today

Support group leaders and other prostate cancer advocates and educators may well be interested in reading two good commentaries in the August issue of AUA News on the pros and cons of active surveillance. … READ MORE …

Active surveillance and African Americans with very low-risk disease

A new study in the Journal of Clinical Oncology has suggested that African American men with very low-risk disease (according to the National Comprehensive Cancer Network or NCCN definition) are at higher risk for disease progression than comparable Caucasian patients if they follow active surveillance protocols. … READ MORE …

Measuring outcomes after treatment for men after active surveillance

A new paper just published in the Journal of Urology has again shown (in a relatively small group of men) that radical prostatectomy appears to be curative for men who have  treatment after an initial on active surveillance, and then some indication of increased risk, but … READ MORE …

Of cost, quality, and care for low-risk prostate cancer

A newly published study in the Annals of Internal Medicine has offered an analysis of the cost-effectiveness of “observation” as compared to immediate initial treatment for men diagnosed with low-risk, localized prostate cancer. … READ MORE …

How active should “active surveillance” really be? Are we being overly cautious?

There are a couple of brief but interesting new articles about active surveillance by Dr. Oliver Sartor and Laurence Klotz on the CancerNetwork.com web site this week. They deal with differing perceptions about the application of active surveillance. … READ MORE …

Recent utilization of active surveillance to defer treatment in Sweden

Although many US urologists and radiation oncologists consider that active surveillance is a highly appropriate form of management for low and very low-risk forms of prostate cancer, the actual use of active surveillance in clinical practice here in the USA is still limited … so it is interesting to see recent data from Sweden on this topic. … READ MORE …

Life expectancy ≤ 10 years and the risks associated with treatment

According to Reuters, a new article, forthcoming on line in the Annals of Internal Medicine, tells us (not too surprisingly) that, “Older men with other illnesses may not live long enough to benefit from aggressive prostate cancer treatments, such as prostate removal or radiation, and they’d have to live with their side effects.” … READ MORE …

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