Patients Shift From Active Surveillance To Active Treatment

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Prostate cancer is one of the deadly diseases in the U.S; the prostate is a small walnut-shaped gland in men and is the reason for the production of seminal fluid.

It is one of the most common types of cancer. Recently around half of the prostate cancer patients moved from active surveillance to active treatment, which includes surgery, radiation therapy, etc.

Patients Shift From Active Surveillance To Active Treatment

“These population-based data show that while the number of patients initiating active surveillance has significantly increased over time, the follow-up shows a relatively high rate of transitioning to other forms of treatment within five years,” Antonio Finelli, MD, FRCSC, of the University.

Patients Shift From Active Surveillance To Active Treatment

In many cases, he has noticed that people are more aware of prostate issues, and hence in case of any trouble they do not hesitate to rush to an expert.

They not only watch the condition but also prefer to have a quick cure that has led to a better recovery ratio among such patients in past some months. For males, this is very necessary to keep a check on any development of pain in the pelvic area as it may be the initial symptom of Prostate cancer.

The study provided us with new data on how long the patients stay in the active surveillance. The researchers also analyzed the data of 8,541 patients who managed using active surveillance; the records were taken from the Ontario health databases.

Active surveillance is a way to monitor slow-growing prostate cancer instead of directly treating it. Active surveillance mainly involves prostate-specific antigen (PSA) screenings, imaging studies, prostate exams, and repeat biopsies. This is done to carefully notice the growth of prostate cancer and also helps in avoiding any unnecessary treatment.

“Unfortunately, despite the fact that most patients with low-risk prostate cancer are managed in community settings, limited real-world data are available on discontinuation rates of active surveillance for patients outside of academic institution cohorts,” according to the study authors.

The authors used general population health data to record the trends in starting and stopping active surveillance.

For around 51 percent of men with low-risk prostate cancer, active surveillance was the initial management plan. The use of active surveillance increased from 38 percent in 2008 to 69 percent in 2014, which is an increase of 31 percent.

The study also noted that on an average of 4 years after the diagnosis of prostate cancer, around 51 percent of the men discontinue the active surveillance and approach for the active treatment like radiation, surgery, or hormone therapy; the shift is mainly due to the vital signs of tumor progression.

The number of men who remained on active surveillance dropped from 85 percent in one year to around 52 percent in five years.

The average time of the active treatment was around 16 months, which mostly reflects the reclassification of patients early. The researchers also noted that around 49 percent of men continued to be on active surveillance, without compromising their quality of life.

Researchers also looked up the reasons for the shift from active surveillance to active treatment. The shift was more probable for young patients and also those who are at a higher risk like higher PSA levels and more positive (showing cancer cells) biopsies.

The researchers said that there is a vital need for a developed imaging process and tests to accurately tell whether the patient needs to shift to treatment or can stay inactive surveillance.

Dr. Finelli adds, “Current practice may be improved by the development of quality indicators, targeted continuing education for physicians, and patient education with shared decision making at the onset of active surveillance.”