Active Surveillance Popularity Grows in Early-State Prostate Cancer

Active surveillance was found to be the preferred treatment choice for men with non-aggressive prostate cancer in Sweden.

A study published in the Journal of the American Medical Association Oncology, researchers concluded that man were more likely to choose active surveillance monitoring when presented with the option. The results of the study showed that more than half of the 32,528 men diagnosed with non-aggressive prostate cancers chose monitoring during a recent 5-year period over immediate treatment.

Active surveillance relies on regular blood tests, physical exams, and periodic biopsies, or sampling of prostate tissue to look for any signs of tumor growth before considering treatment. Using active surveillance averts the risk of sexual dysfunction, bowel and bladder problems.

“The main conclusion here is that if the majority of men in Sweden have adopted this management strategy for very low- to low-risk prostate cancer, then more American men might choose this option if it were presented to them,” said lead study investigator Stacy Loeb, MD, MSc.

A key finding from the analysis was an increase in the number of Swedish men with very low-risk cancer who were choosing active surveillance. In fact, from 2008 to 2014, use of this option rose from 40% to 74%. Furthermore, the choice of watchful waiting dropped by more than half.

Researchers collected and analyzed data from Sweden’s National Prostate Cancer Register for the study.

“Our findings should encourage physicians and cancer care professions in the United States to offer such close supervision and monitoring to their patients with low-risk disease,” Loeb said.

Authors noted that although there is an increase in the amount of American men with early-stage prostate cancer who are choosing active surveillance, they still comprise less than half of those for whom it is an option.

“[More American men opting for active surveillance] could go a long way toward reducing the harms of screening by minimizing overtreatment of non-aggressive prostate cancer,” Loeb said.

Recent studies have suggested that some men with early-stage prostate cancer who choose to undergo treatment later ended up regretting it because of lingering problems, such as impotence and incontinence. Furthermore, a large study revealed that a there was no difference in death rates a decade after diagnosis between those who chose immediate treatment and active surveillance.

There is a greater risk of side effects for men who do choose treatment, however, researchers noted that this pattern has not been confirmed in the Swedish study. It’s estimated that 26,000 men in the United States will die from this disease in 2016.