Expert opinions on prevention, screening, and active surveillance


There are three new and useful resources now available related to the prevention of prostate cancer, screening for prostate cancer, and the role of active surveillance in the expectant management of prostate cancer.

In The Lancet Oncology, Cuzick et al., have offered a thorough review of data related to the prevention and early detection of prostate cancer which emphasizes the importance of a variety of risk factors — age, race, and geography; familial and genetic factors; external exposure to radiation of various types; urinary tract infections; smoking; diet, weight, and physical activity; and endogenous hormones. They note that the use of 5α-reductase inhibitors (e.g., finasteride and dutasteride) is the only form of management definitively proven to be associated with a reduction in the risk for a diagnosis of prostate cancer. While there are strong data supporting the idea that regular aspirin users also have a reduction in risk for a diagnosis of prostate cancer, this has never been proven in a clinical trial. This is certainly a useful article for  support group leaders and other prostate cancer educators to obtain and read (if you can access the full text at your local library or through other sources).

On the UroToday web site, there are two new video presentation that might make useful materials for review or for discussion and support group meetings.

The first is a 42-minute-long presentation by Dr. Laurence Klotz on the present and future role of active surveillance in the management of low-risk prostate cancer (and intermediate-risk prostate cancer in older men with a limited life expectancy). Dr. Klotz goes into great detail about everything from the extreme unlikelihood for metastasis of any prostate cancer with a Gleason score of 6 or less to the evolving role of MRI scanning and MRI/TRUS-fusion biopsies in the monitoring of patients on active surveillance. For those readers who are seeking a detailed understanding of the application of active surveillance today, this video is well worth 42 minutes of your time, and one could project it, with the audio at a support group meeting if the relevant equiment was available.

The second video on the UroToday site is shorter (about 10 minutes), with Dr. Stacy Loeb discussing her recent “guideline on guidelines” related to screening for prostate cancer. We have already discussed this article previously, and the full text of the article itself is also available on line.

Access to the information on the UroToday web site is freely available to patients and to prostate cancer educators, but you do have to register to join the site.

3 Responses

  1. Great info, thanks!!!

  2. I’ve taken baby aspirin and finasteride (Proscar) for years and I still got prostate cancer. [In my case] genetic disposition is still more important. I have a huge genetic risk with prostate cancer diagnosed in four uncles (three of whom are dead secondary to bone metastasis) and a maternal grandfather as well. Looking at proton therapy or robot-assisted surgery.

    Ron Rosen

  3. Mr. Webmaster,

    I think this a great audio on active surveillance, the difference between a Gleason 3 and 4 in cancer definition, importance of targeted biopsies, the value of 5-ARIs, etc. It would be great if you could provide a written summary of the 42 minutes to better spread the good news.

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