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Prostate tumors not likely to worsen during active surveillance period in low risk patientsJohns Hopkins experts have found that men enrolled in an active surveillance program for prostate cancer that eventually needed surgery to remove their prostates fared just as well as men who opted to remove the gland immediately, except if a follow-up biopsy during surveillance showed high-grade cancer. Active surveillance, also known as watchful waiting, is an option open to men whose tumors are considered small, low-grade and at low risk of being lethal. Active surveillance is based on fact that, given the potential complications of prostate surgery and likelihood, certain low-risk tumors do not require treatment. Thus some men opt to enroll in active surveillance programs to monitor PSA levels and receive annual biopsies to detect cellular changes that signal a higher grade, more aggressive cancer for which treatment is recommended. Yet, according to the Johns Hopkins experts, there is concern that delaying surgery in this group until biopsy results worsen may result in cancers that are more lethal and difficult to cure. The experts compared the pathology results of men in an active surveillance group at Johns Hopkins who later had surgery with those who also had low-risk tumors and opted for immediate surgery. Results initially showed that 116 active surveillance participants who had surgery were more likely to have high-grade, larger tumors than 348 men who had immediate surgery. But study leader says that these results were found only in 43 (37 percent) men in the surveillance group who were recommended for surgery because a follow-up biopsy during surveillance worsen to indicate a high-grade tumor. Apart from the 43 men whose pathology results worsened during surveillance, the remaining men in the surveillance group had similar pathology results at surgery to those in the immediate surgery group. This means, in experts' opinion, that most tumors are not likely to worsen during the period of active surveillance. The researchers calculate that the risk of finding high-grade tumors in the entire group of 801 active surveillance patients is low -- about 4.5 percent per year. Based on abstracts and presentations by Johns Hopkins Kimmel Cancer Center scientists scheduled to present their work at the annual meeting of the American Society of Clinical Oncology (ASCO), June 4-8, in Chicago. Source: Johns Hopkins Medical Institutions 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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