Health

Many not following protocol for 'active surveillance' of prostate cancer

Dr. Katsuto Shinohara (L) and Dr. I-Chow Hsu review images of a prostate with cancer before performing a bracytherapy operation on a man with prostate cancer at the UCSF Comprehensive Cancer Center.
Dr. Katsuto Shinohara (L) and Dr. I-Chow Hsu review images of a prostate with cancer before performing a bracytherapy operation on a man with prostate cancer at the UCSF Comprehensive Cancer Center.
(Justin Sullivan/Getty Images)

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The vast majority of men who choose "active surveillance" of their low-risk prostate cancer are not getting the required care, according to a UCLA study published Tuesday.

Active surveillance allows men with less serious prostate cancer to avoid the potentially damaging side effects of radiation and surgery,  which can include urinary and erectile dysfunction. Key to that "watch and wait" approach  is careful monitoring of the cancer, which typically entails regular blood tests and doctor visits.  Some men also require annual biopsies.

But the UCLA research, published Tuesday in the journal Cancer, found that more than 95 percent of the men in the study who opted to forgo treatment failed to get the appropriate follow-up care. And that, the study concluded, left them at risk of having their cancer grow and spread. 

Researchers examined the records of more than 37,000 men 65 and older who were diagnosed with prostate cancer between 2004 and 2007, and followed them until 2009.  Of that group, 3,656 chose active surveillance. A review of their records found only 166 - or 4.5 percent - received appropriate follow-up monitoring, according to Dr. Karim Chamie, director of UCLA’s bladder cancer program and the study's lead author. 

Further research is needed to determine why so few who choose active surveillance are getting the recommended care, according to Chamie and his associates.

"Many researchers have been advocating for active surveillance for men with low-risk disease," said Chamie. "However, this study suggests that before we advise our patients to pursue active surveillance for their prostate cancers, we should be certain that we are committed to closely monitoring the cancers with a repeat biopsy, PSA testing and physical exams."