How to decide whether or not to start treatment for prostate cancer?

How to decide whether or not to start treatment for prostate cancer?

You have been diagnosed with prostate cancer and your doctor gives you the option of not being treated, but of remaining under observation: is there any objective way you can decide to be treated or not treated? What should you do? Now using first results from analysis of the world's biggest Active Surveillance prostate cancer database, the GAP3 consortium has begun to identify which patients are at risk of the disease developing and which patients can continue to safely delay treatment. This work is presented at the virtual European Association of Urology congress. As lead researcher, Dr Mieke Van Hemelrijck (King's College London) says: "Current methods of deciding whether or not to recommend treatment are not reliable. Our analysis shows that we should be able to produce a single global methodology, which will give accurate estimates on how aggressive these cancers are. These will feed directly into the treatment decision, and give men the reassurance they need to decide on treatment". Prostate cancer is one of the leading causes of death in men, but many men who discover they have prostate cancer are not in any immediate danger: they have Low Risk Prostate Cancer. Over the past 10 years, an increasing number of these men have been given the option of going on active surveillance, rather than being immediately treated. Active surveillance means that men continue to be monitored and tested (via PSA levels, biopsy, and other tests), with treatment only starting when the cancer shows signs of developing. The number of men on active surveillance varies from country to country, with up to 80% of men delaying treatment in some countries. However, there are no generally accepted ways of understanding who is at risk, and as many as 38% of men who start active surveillance drop out within 5 years. Van Hemelrijck said: "Prostate cancer treatment can have significant side-effects such as erectile dysfunction and incontinence, so often avoiding intrusive surgery or radiotherapy can benefit the patient. Nevertheless, being told you have cancer puts great psychological pressure on men to agree to treatment, so understanding just how aggressive the cancer is before deciding on treatment is essential. At the moment we just don't have that reassurance". Related Stories



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