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From the Spring 2016 Quest
An increasing number of men diagnosed with low-risk prostate cancer are choosing active surveillance in hopes of avoiding side effects of surgery and radiation. However, a new study by UCLA researchers found that less than 5% of men who choose active surveillance are monitored as closely as they should be. This puts them at risk of their cancers progressing or metastasizing without their knowledge.

The researchers examined the records of 37,687 men in the Surveillance, Epidemiology, and End Results (SEER)-Medicare data. Of the 3,656 men who chose to leave their cancers untreated, only 4.5% were being monitored appropriately. The study defined recommended follow-up care as having a PSA test and doctor visit every 6 months and a repeat biopsy within 2 years of diagnosis.

Men who underwent aggressive treatment for their prostate cancer were more likely to have routine lab testing and doctor visits.

Dr. Karim Chamie, the study’s first author and an assistant professor of urology at UCLA, said, “Many researchers have been advocating for active surveillance for men with low-risk disease. However, this study suggests that before we advise our patients to pursue active surveillance for their prostate cancers, we should be certain that we are committed to closely monitoring the cancers with a repeat biopsy, PSA testing and physical exams.”

The study did find a small but statistically significant increase in follow- up intensity over time, meaning that as time elapsed after diagnosis, the men who elected active surveillance were more likely to receive the recommended follow-up tests.

This is the first population-based study to compare the follow-up intensity of American men with prostate cancer who have elected not to have treatment compared to those who had aggressive treatment, such as surgery and radiation.

The study was published in the journal Cancer.

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