A respected voice emphasizes the need for change

In a state-of-the-art lecture delivered at the ongoing World Robotic Urology Symposium earlier today, Dr. Peter Scardino, the Chairman of the Department of Surgery at Memorial Sloan-Kettering Cancer Center, apparently added his voice to some significant calls for reassessment of the way early stage prostate cancer is currently managed in the USA.

Among the key points made by Dr. Scardino in his lecture were the following:

  • The current use of the PSA test is probably leading to over-diagnosis of insignificant prostate cancers.
  • There should be greater concern about over-treatment in these patients.
  • In view of the increased diagnosis of potentially clinically insignificant tumors, active surveillance may be a very appropriate form of care in carefully selected patients.
  • Given the potential morbidity of radical prostatectomy, as presented by Sanda et al. in their prospective study published in March 2008, the use of medical therapy with agents such as finasteride or dutasteride in select patients needs greater investigation.

The “New” Prostate Cancer InfoLink is very pleased to see a urologic oncologist of Dr. Scardino’s stature take these positions. Change is hard for people to deal with, and we need leadership from respected members of the medical profession as we move into a new phase of the war on prostate cancer. Most particularly, it will be in the greatest long-term benefit of the majority of patients if we can foster the discovery and development of methods that will allow greater accuracy in early diagnosis and less aggressive forms of management for patients at least risk of progressive disease, so that their quality of life can be maximized.

Such advances will take time — but they will come more quickly as we start to move away from the ingrained beliefs of the past and give full attention to the real needs of patients: which imply high quality of care with minimum risk.

One Response

  1. You left off his comments about the need to investigate the role of focal therapies such as partial prostate ablation in patients with low volume tumors.

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