PROSTATE CANCER MANAGEMENT - Active Surveillance


What does a man have to lose on active surveillance?

The major concern is that while surveillance is taking place, the tumor will progress beyond the prostate to the point where cure is no longer possible. Researches at Johns Hopkins and the University of California San Francisco (UCSF) collaborated with experts at the National Cancer Institute to compare men that underwent surgery immediately versus those that entered active surveillance. The researchers constructed a computer simulation using the data from Johns Hopkins and UCSF to find out if men in surveillance were compromising their chance of avoiding a prostate cancer death. The model projected the following:

  • 2.8% of men on surveillance versus 1.6% of men undergoing immediate surgery would die of prostate cancer in 20 years
  • 3.4% of men on surveillance versus 2.0% of men undergoing immediate surgery would die of prostate cancer during their lifetime
  • The average projected increase in life expectancy attributed to surgery was 1.8 months and men in surveillance would –on average- remain free of treatment for an additional 6 years

The study investigators concluded that surgery was likely to produce a very modest decline in prostate cancer death as compared to surveillance; and that surveillance could lead to significant benefits in terms of quality of life.