The TOAD trial: follow-up data on quality of life

Some 15 months ago, we reported the initial, primary results of the TOAD trial, which showed an overall survival benefit for immediate as opposed to delayed initiation of androgen deprivation therapy (ADT) in non-metastatic patients considered to be inappropriate for curative therapy. … READ MORE …

Can a man be too young for active surveillance?

There is a “conventional wisdom” that active surveillance (AS) is only for older men, and that younger men are better off having immediate radical treatment, typically prostatectomy (RP).

Has TOAD resolved a real and long-standing question?

So TOAD stands for “Timing of Androgen Deprivation” and refers to a randomized, multi-center, Phase III trial carried out in Australia, New Zealand, and Canada between September 3, 2004, and July 13, 2012. … READ MORE …

Just “delaying” surgery does increase risk … but it’s not active surveillance

A key question for men diagnosed with low-risk prostate cancer is always going to be whether, and for how long, they can defer treatment without increasing the risk that delayed treatment will be less effective (or riskier) in some ways. … READ MORE …

What should one do if one’s PSA remains detectable after radical prostatectomy?

After surgery, PSA should become “undetectable” on a normal PSA test (i.e., < 0.1 ng/ml) within a month or two, but sometimes it remains elevated. The primary purpose of the ARO 96-02 randomized clinical trial was to determine whether there was an advantage to treating stage T3-4N0 patients while PSA was still undetectable, or whether they could wait to be treated. … READ MORE …

Deferred or immediate initiation of ADT in patients with PSA-only relapse

Abstracts of all papers to be presented at the upcoming annual meeting of the American Society of Clinical Oncology (ASCO) were made available for pre-meeting review yesterday. A paper on the appropriate timing of initiation of androgen deprivation therapy (ADT) was featured by ASCO in its related news conference. … READ MORE …

Immediate vs. deferred radical prostatectomy for localized prostate cancer

A retrospective analysis of data from the Swedish National Prostate Cancer Register suggests that deferring radical prostatectomy for a year or more has minimal impact on prostate cancer-specific survival for men with localized prostate cancer. … READ MORE …