Cancerworld Magazine
  • About the Magazine
    • About us
    • Editorial Team
    • Events
    • Archive
    • Contacts
  • Articles
    • Policy
    • Practice Points
    • Delivery of Care
    • Biology basic
    • Medicine
    • Featured
  • Contents
    • News
    • Editorials
    • Interviews to the Expert
    • In the Hot Seat
    • Profiles
    • Obituaries
    • Voices
  • ESO College Corner
SUBSCRIBE FOR FREE
Facebook
Twitter
LinkedIn
Cancerworld Magazine
Cancerworld Magazine
  • About the Magazine
    • About us
    • Editorial Team
    • Events
    • Archive
    • Contacts
  • Articles
    • Policy
    • Practice Points
    • Delivery of Care
    • Biology basic
    • Medicine
    • Featured
  • Contents
    • News
    • Editorials
    • Interviews to the Expert
    • In the Hot Seat
    • Profiles
    • Obituaries
    • Voices
  • ESO College Corner
Cancerworld Magazine > News > Low risk prostate cancer: real-world data reveals high rates of switching from surveillance to treatment
  • News

Low risk prostate cancer: real-world data reveals high rates of switching from surveillance to treatment

  • 10 September 2021
  • Janet Fricker
Doctor consulting with patient and checking sickness condition while presenting results diagnosis symptom examining about the problem of illness and recommend treatment method, Healthcare and medical.
Low risk prostate cancer: real-world data reveals high rates of switching from surveillance to treatment
Total
0
Shares
0
0
0
0
0

Over half of men initially managed with active surveillance (AS) for ‘low risk’ prostate cancer switch within four years to definitive treatments (e.g., surgery or radiation therapy). The Canadian study, published in Urology, (20 August) provides real-world data on uptake and discontinuation of AS, as well as exploring factors influencing likelihood of treatment switching.

Active surveillance (also known as ‘watchful waiting’) is used to monitor slow-growing ‘low-risk’ or localized PC, with the aim of avoiding or delaying unnecessary treatment and its side effects. AS, which has become standard of care for PC worldwide, involves regular prostate-specific antigen (PSA) screening, prostate exams, imaging studies, and repeat biopsies. Despite most men with low-risk PC being managed in the community, limited real-world data is available on discontinuation rates outside of academic institution. In a recent systematic review of 45 real world PC treatment observation studies, only six studies reported rates of AS discontinuation.

In the current study, Antonio Finelli, from University of Toronto, Canada, and colleagues set out to evaluate changes in real-world initial AS uptake over time, rates of discontinuation and characteristics associated with uptake and discontinuation. Using Ontario health databases, investigators analysed 8,541 men diagnosed with low-grade PC between January 2008 and December 2014 and initially managed using active surveillance (mean age 64 years). The Ontario Health Insurance Plan (OHIP) physician fee code database was used to identify all PC-related interventions.

Results showed AS was the initial management strategy for 51% of men diagnosed with low-risk PC. Use of AS increased from 38% of patients diagnosed in 2008 to 69% in 2014. However, at a median follow-up of four years after PC diagnosis, 51% of men had discontinued AS and proceeded to definitive treatment (including surgery, radiation or hormone treatment). Of men who received definitive treatment after AS, 52% underwent radical prostatectomy, 34% radiotherapy (RT) with Androgen Deprivation Therapy (ADT), 6% RT alone and 4.7% with ADT alone. The median time to definitive treatment after initial AS was 16 months. The cumulative probability of remaining on AS was 85.2% at one year, 62.9% at two years, 58.0% at three years, 55.3% at four years, and 52.4% at five years.

On multivariable analysis, factors associated with AS discontinuation were younger age at diagnosis, higher comorbidities, treatment at an academic centre (vs non-academic), treatment by radiation oncologist (vs urologist), treatment by higher volume physician and/or institution, and worse disease characteristics (higher PSA, positive cores and maximum % core at diagnosis).

The long-term discontinuation rates reported in the study, write the authors, are significantly higher than those reported by single institution academic centres (discontinuation rates of 24-41%). “This has implications for patient counselling and setting realistic expectations,” they add.

The increased uptake of AS, they suggest, reflects greater comfort with concept, the adoption of guidelines and governing agencies supporting the approach.

To guide selection of AS over immediate treatment, the authors stress, the importance of developing more specific tests. “There is a dire need to develop robust tests such as biomarkers and advanced imaging to move the field beyond nonspecific measures (i.e., PSA) and invasive prostate biopsy. Competing health risks and patient characteristics should be combined with disease-specific traits to better select patients for inclusion,” conclude the authors.

Total
0
Shares
Share 0
Tweet 0
Share 0
Share 0
Share 0
Related Topics
  • active surveillance
  • observational study
  • prostate cancer
  • treatment switching
  • watchful waiting
Janet Fricker

Janet Fricker is a medical writer specialising in oncology and cardiology. After researching articles for Cancerworld she runs, swims, and eats porridge.

Previous Article
  • News

Careers of women in oncology hit by Covid-19 pandemic

  • 2 September 2021
  • Swagata Yadavar
View Post
Next Article
  • News

Cancer World Editor heads new AACR cancer prevention working group

  • 13 September 2021
  • Janet Fricker
View Post
You May Also Like
View Post
  • Articles
  • Medicine
  • News

Common Diabetes Medication Could Protect Heart Health During Cancer Treatment

  • Janet Fricker
  • 30 May 2025
View Post
  • Articles
  • News

CancerWorld issue #103 (May, 2025)

  • Yeva Margaryan
  • 11 May 2025
View Post
  • News

Personalised neoantigen vaccine for kidney cancer shows promise in phase 1 study

  • Janet Fricker
  • 8 May 2025
View Post
  • News
  • Senza categoria

What Caught Our Eye in April: Oncology’s Top Moments

  • Janet Fricker
  • 7 May 2025
View Post
  • News

CancerWorld #102 (April 2025)

  • Yeva Margaryan
  • 22 April 2025
View Post
  • News
  • Senza categoria

What Caught Our Eye in March: Oncology’s Top Moments

  • Janet Fricker
  • 8 April 2025
View Post
  • News

Ovarian cancer: mechanism conferring resistance to immunotherapy revealed

  • Janet Fricker
  • 21 March 2025
View Post
  • News

Muscular strength and cardiorespiratory fitness improve survival in cancer patients

  • Janet Fricker
  • 20 March 2025
search
CancerWorld #101 Download CancerWorld #101 Download CancerWorld #101 Download or search in Cancerworld archive
Newsletter

Subscribe free to
Cancerworld!

We'll keep you informed of the latest features and news with a fortnightly email

Subscribe now
Latest News
  • Common Diabetes Medication Could Protect Heart Health During Cancer Treatment
    • 30 May 2025
  • CancerWorld issue #103 (May, 2025)
    • 11 May 2025
  • Personalised neoantigen vaccine for kidney cancer shows promise in phase 1 study
    • 8 May 2025
  • What Caught Our Eye in April: Oncology’s Top Moments
    • 7 May 2025
  • CancerWorld #102 (April 2025)
    • 22 April 2025
Article
  • Albinism And Skin Cancer In Africa: Tackling The Prevention Needs Of A Stigmatised Population
    • 30 May 2025
  • Common Diabetes Medication Could Protect Heart Health During Cancer Treatment
    • 30 May 2025
  • Why Patient-Reported Outcomes are Rarely Used in Trials, and How We Change That
    • 27 May 2025
Social

Would you follow us ?

Contents
  • A Promise Kept: How Samvel Danielyan Lifted Pediatric Cancer Survival from Zero to 70%
    • 25 May 2025
  • Together, She Changed Everything: Martine Piccart ’s Fight Against Breast Cancer
    • 20 May 2025
  • Adrian Gottschalk: Making a Difference for His Fellow Human Beings
    • 10 May 2025
MENU
  • About the Magazine
    • About us
    • Editorial Team
    • Events
    • Archive
    • Contacts
  • Articles
    • Policy
    • Practice Points
    • Delivery of Care
    • Biology basic
    • Medicine
    • Featured
  • Contents
    • News
    • Editorials
    • Interviews to the Expert
    • In the Hot Seat
    • Profiles
    • Obituaries
    • Voices
  • ESO College Corner
Cancerworld Magazine
  • About us
  • Articles
  • Media Corner
  • Privacy Policy
  • Cookie Policy

Cancerworld is published by OncoDaily (P53 Inc.) | Mailing Address: 867 Boylston st, 5th floor, Ste 1094 Boston, MA 02116, United States | [email protected]

Archivio Cancerworld

Input your search keywords and press Enter.