Four in 10 Men with Prostate Cancer May Avoid Radical Treatment
19 October 2010 - Hundreds of men in the UK are opting to delay aggressive treatment for prostate cancer in favour of being closely monitored, according to the first figures on the groundbreaking new care approach.
Dr Chris Parker from the ICR and The Royal Marsden pioneered the technique of Active Surveillance, which since 2008 has been recommended by the National Institute for Health and Clinical Excellence (NICE) as an option for patients with low-risk, localised prostate cancer.
Under Active Surveillance, men are regularly monitored by biopsy and testing levels of prostate specific antigen (PSA) in the blood to see if their cancer progresses. There is currently no test to distinguish between aggressive prostate cancers and cancer that would never require treatment, so Active Surveillance can be used to ensure men only receive therapy and risk the corresponding side-effects if they genuinely need it.
Dr Parker analysed 43,322 cases of localised prostate cancer recorded between 2002 and 2006 on the British Association of Urological Surgeons (BAUS) Cancer Registry. About 20 per cent of these men – around 8,800 - met the criteria for low-risk disease based on PSA level, physical examination and biopsy results.
From 2002 until 2006, the proportion of men in this group who opted for Active Surveillance increased from zero per cent to 39 per cent. Consequently, the proportion of patients opting for surgery and radiotherapy declined over the same period, from 27 per cent to 15 per cent and 23 per cent to nine per cent respectively. Dr Parker says Active Surveillance has likely become even more common since NICE made it a standard treatment option.
“This growth in Active Surveillance use represents a significant shift of clinical practice in Britain,” Dr Parker says.
