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Prostate Cancer: When To Wait And When To TreatPeter Nelson, M.D., of the Hutchinson Center's Clinical Research and Human Biology divisions, will lead the Canary Prostate Consortium. This group of six institutions nationwide will enroll men in a cancer-surveillance study to look for biomarkers -- proteins in the blood that could predict prostate-tumor aggressiveness. The new study is meant to help answer a key question that has vexed physicians and researchers: When is it best to treat prostate cancer versus to wait or "watchful waiting." For most men with prostate cancer, the disease never progresses to become a serious health problem, yet most receive some sort of treatment, such as radiation or surgery. Such treatments can have side effects, such as impotence and incontinence, which can be worse than the low-grade cancer. Currently it is challenging to accurately predict when inactive or slow-growing prostate tumors will become aggressive. "There's an emerging consensus that we dramatically over treat prostate cancer in general," said Nelson. "The overall prevalence of the disease in the population far exceeds the number of men whose disease progresses to cause serious problems. Yet, there are clearly many prostate cancers that behave aggressively and patients benefit from treatment. It is a challenging problem." In the study, men diagnosed with early-stage prostate cancer will not be treated right away but will be closely followed in an active surveillance program involving regular collection of blood and urine samples as well as prostate biopsies. A new repository for blood and DNA samples will be located at the Hutchinson Center. The repository will be funded by the Canary Foundation. NCI's Early Detection Research Network (EDRN), the federal agency that is partnering with the Canary Foundation, will establish disease-specific Common Data Elements, a biospecimen management system and a protocol oversight program. The EDRN data management and coordinating center is based at the Hutchinson Center under the direction of Zideng Feng, Ph.D., a member of the Hutchinson Center's Public Health Sciences Division. The samples will be tested for candidate biomarkers -- proteins in the blood -- that can signal when indolent disease has progressed to more aggressive illness. Such biomarkers could help physicians better determine when to initiate treatment versus watchful waiting. Each of the study institutions also has a "retrospective" tissue collection of samples taken from unrelated studies. These will also be examined to ascertain the accuracy of predictive biomarkers. "We are proud to launch this new study with EDRN and with the participation of leading research institutes," said Nelson, who is also a professor of oncology at the University of Washington School of Medicine. "Through collaboration we can make bigger strides in providing better, more individualized treatment for prostate-cancer patients." The Canary Foundation is providing initial funding for the Prostate Active Surveillance Study. The five institutions that will enroll patients are University of Washington, Stanford University, University of California at San Francisco, University of British Columbia and University of Texas Health Science Center in San Antonio. NOTE: Issues on this site regarding men's health and their concerns, 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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