Active Surveillance

According to new data reported at the annual meeting of the European Association of Urology in London, active surveillance of men diagnosed with low-risk prostate cancer was not associated with an elevated risk for metastatic disease at 15 years of follow-up. Read the article here.

A man’s race/ethnicity might influence decision-making regarding opting for active treatment as well as undergoing serial biopsies during active surveillance, according to a recent study. Read the article here.

Howard Wolinsky, a journalist based in the Chicago area, was diagnosed with early prostate cancer in 2010. After over 5 years of active surveillance, he describes his continuing quest to make the best — and most informed — decision about his care. Read the article here.

The introduction of multiparametric MRI (mpMRI) has improved the diagnosis and risk stratification of intermediate and high-risk prostate cancer. In addition to diagnosis, mpMRI has increasingly become a useful tool for monitoring the prostate cancer risk of patients on active surveillance (AS) programmes. Long-term data indicates that there is no oncological benefit for AS programmes for patients diagnosed with intermediate risk prostate cancer. Further, there is increasing evidence that PI-RADS 4 lesion on mpMRI correlates with intermediate and high-risk prostate cancer. Read the article here.

A new care model for patients with low-risk prostate cancer may help prevent disease overtreatment. This evidence-based approach uses best practices to select patients to avoid disease overtreatment. Results from a 3-year study recently published in Urology indicate that active surveillance (AS) rates nearly doubled after this model was adopted. Read the article here.

To examine the feasibility of active surveillance for low volume Gleason sum (GS) 3 + 4 disease compared to GS 3 + 3 disease. Retrospective review of 929 patients, with biopsy proven GS 3 + 3 and 3 + 4 PCa, undergoing upfront radical prostatectomy (RP) was performed. Read the article.

Investigators at the Sunnybrook Health Sciences Centre, University of Toronto initiated a study to assess the risk factors for metastases in patients on active surveillance. About three percent of patients on surveillance had metastasis by a median of seven years after diagnosis. This risk increased to ten percent in patients with Gleason score (GS) 7. Read the article.

A panel of experts at the American Society of Clinical Oncology (ASCO) have reviewed and endorsed Cancer Care Ontario’s guideline on Active Surveillance for the Management of Localized Prostate Cancer. The guidelines, published in May 2015, “are clear, thorough, and based upon the most relevant scientific evidence,” wrote Ronald C. Chen, MD, MPH, associate professor in the department of radiation oncology at UNC-Chapel Hill, and coauthors. Read the article.