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Who is really a candidate for active surveillance (watchful waiting)A recent study at Northwestern Feinberg School of Medicine, Chicago, Illinois, aimed to examine the treatment outcomes of men who would have been eligible for active surveillance (watchful waiting) but underwent immediate radical retropubic prostatectomy (RRP). Active surveillance (watchful waiting) protocols are designed to spare the potential morbidity of treatment to patients with low-risk prostate cancer (PCa) as well as anxiety and distress for early prostate cancer. The research team concluded that watchful waiting protocols are designed to spare the potential morbidity of treatment to patients with low-risk prostate cancer.This is completely true, but for the patient an AS protocol also does something else. It gives him — and often his spouse – time to be certain that they are making the right decision. In other words, from the patient’s point of view, active surveillance means either possibility that he really does have indolent disease that will never need to be treated, either possibility that he does need prostate cancer treatment — but not immediately. The study authors concluded that a substantial proportion of men who might have been considered potential watchful waiting candidates had aggressive tumor features at RRP and/or progression. The strongest predictor of a dverse outcomes, was Biopsy Gleason score >6 was . It was highlighting the importance of limiting active surveillance to patients with Gleason Indeed, it may not even be possible to come up with any “absolute” guidelines for eligibility for AS based on the diagnostic and prognostic tools we have at this time. However, one of the things that we don’t seem to be taking into account in analyzing the value of AS is the value of not needing immediate intervention for the patient (i.e., “deferred” treatment). NOTE: Issues on this site regarding prostate cancer and treatment options, are provided for information only, and are not meant to substitute for the advice of your own physician or other medical professional. Prostate-Report.org does not endorse any specific product, service or treatment. |
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