Watch-and-Wait Strategy May Be Riskier for Certain Prostate Cancers


MONDAY, Feb. 23, 2015 (HealthDay News) — Choosing active surveillance over treatment for prostate cancer may decrease the odds of survival in men with intermediate-risk cancer, a new study says.


The risk of death over 15 years for men with intermediate-risk prostate cancers who chose close monitoring of their disease was nearly four times higher compared to men with low-risk disease, according to the study.


Researchers analyzed data from 945 prostate cancer patients in Canada between 1995 and 2013. All had chosen active surveillance — also called watchful waiting — of their disease. Almost 250 of the men had intermediate-risk prostate cancer. About 700 had low-risk cancer.


If cancer got worse during watchful waiting, patients were offered radiation therapy or surgery. Eighty-six men in the intermediate-risk group received treatment, according to the researchers.


Overall survival rates after 10 and 15 years were 68 percent and 50 percent for intermediate-risk patients. That compared to 84 and 69 percent for low-risk patients, the study noted.


Overall, the researchers found that patients with intermediate-risk disease were almost 4 times more likely to die than those with low-risk disease.


The study is scheduled to be presented at an upcoming American Society for Clinical Oncology (ASCO) meeting.


“For low-risk patients with prostate cancer managed with active surveillance, the risk of dying of prostate cancer is low, validating this approach for this group of patients,” Dr. D. Andrew Loblaw, a radiation oncologist at Sunnybrook Health Sciences Centre in Toronto, said in an ASCO news release.


But, he added, more research is needed to figure out which intermediate-risk patients can safely be monitored and which patients need treatment sooner.


This is the first study to compare long-term outcomes of low- and intermediate-risk prostate cancer patients on active surveillance, according to Loblaw and his colleagues.


Active surveillance is considered a standard approach for prostate cancer patients with low-risk disease, as well as for some intermediate-risk patients, the researchers said.


More information


The American Cancer Society has more about prostate cancer.














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