With the use of active surveillance surged between 2010 and 201
"Overall, these numbers are a good sign and a good thing," he said. "From 2010 to 2015 there have been many new trials – the highest level of evidence we can obtain in medicine, which are prospective studies and some of these randomized trials – that have shown that active surveillance, conservative approaches or non-approaches therapeutic therapies of low-risk prostate cancer have very favorable outcomes. "
" This study really is the reference point "
Among men with intermediate-risk illness, between 2010 and 2015, active surveillance increased from 5.8% to 9.6%; prostatectomy decreased from 51.8% to 50.6%; and radiation therapy went from 42.4% to 39.8%, the researchers found.
Among men with high-risk illness, active surveillance remained almost unchanged, from 1.9% to 2.2%; prostatectomy increased from 38% to 42.8%; and radiotherapy decreased from 60.1% to 55%, the researchers found.
The study presented some limitations, including that of analyzing trends only within a period of five years. Further research is needed to determine trends over a longer period of time and how these trends could impact public health. The study also lacked data on whether patients actually met their doctors' orders on active surveillance or other management approaches.
Yet, on the whole, "this study really is the benchmark for what surveillance rates are in the United States," Mahal said.
"There were other studies that looked at the same question and found increasing rates, but those studies were done with smaller databases or databases that did not collect this type of information," he said. "Furthermore, it is important to continue to follow these trends to know for sure what are the rates of management in the United States, and also to know in the population, how patients do on active surveillance."
"A major change in medical practice"
category of low-risk prostate cancer, what we now know is that the prognosis is quite good even without treatment, "said Loeb, who was not involved in the new research but was the first author of the last year's study
When it comes to radiation or prostatectomy, "these treatment options have potential side effects, such as the impact on erectile function, urination and, in some cases, intestinal function," he said "So it's a tempting option for men to monitor cancer and then receive delayed treatment as needed, if over time there are signs that cancer is becoming more aggressive."
"We really came A long way in trying to better understand how to screen prostate cancer and, once discovered prostate cancer, how to treat prostate cancer and understand that not everyone needs to remove or irradiate his prostate, "said Lichtenfeld.
"That does not mean they can never need radiation or surgery. The whole point of observation of these men is to find out if their prostate cancer changes its behavior over time, if it becomes more aggressive, so give treatment to those who really need it, "he said. "This is a big change in medical practice."