Active surveillance for prostate cancer: patient selection and management
- PMID: 20882126
- PMCID: PMC2935703
- DOI: 10.3747/co.v17i0.713
Active surveillance for prostate cancer: patient selection and management
Abstract
Screening for prostate cancer using prostate-specific antigen (PSA) has been appealing. However, the significant associated decline in prostate cancer mortality comes at the cost of a very high rate of diagnosis, and many patients with indolent, non-life-threatening cancer are exposed to the risk of significant side effects from radical treatment. Most men with favourable-risk prostate cancer are not destined to die of their disease, even in the absence of treatment. The challenge is to identify the subset that harbour more aggressive disease early enough that curative therapy is still a possibility, thereby allowing the others to enjoy improved quality of life, free from the side effects of treatment. This article reviews current research into active surveillance in favourable-risk disease and some of the issues that arise when prostate cancer is monitored rather than being treated immediately.
Keywords: Cancer screening; active surveillance; overdiagnosis; psa.
References
-
- Jemal A, Siegel R, Ward E, Hao Y, Xu J, Thun MJ. Cancer statistics, 2009. CA Cancer J Clin. 2009;59:225–49. - PubMed
-
- Welch HG, Black WC. Overdiagnosis in cancer. J Natl Cancer Inst. 2010;102:605–13. - PubMed
-
- Schröder FH, Hugosson J, Roobol MJ, et al. Screening and prostate-cancer mortality in a randomized European study. N Engl J Med. 2009;360:1320–8. - PubMed
-
- Roobol M, Kerkhof M, Schroder F, et al. Prostate cancer mortality reduction by prostate-specific antigen-based screening adjusted for nonattendance and contamination in the European Randomised Study of Screening for Prostate Cancer (erspc) Eur Urol. 2009;56:584–91. - PubMed
-
- Sakr WA, Haas GP, Cassin BF, Pontes JE, Crissman JD. The frequency of carcinoma and intraepithelial neoplasia of the prostate in young male patients. J Urol. 1993;150:379–85. - PubMed
LinkOut - more resources
Full Text Sources
Research Materials
Miscellaneous
