A study has revealed that nearly half of Canadian men who opt for active surveillance to manage their ‘low-risk’ prostate cancer switch to active treatment – such as surgery or radiotherapy – within five years of diagnosis.
The study, carried out by a team from the University of Toronto and funded by a Movember Discovery Grant in 2013, analysed data collected from 8,541 men on active surveillance to reveal factors that typically influence the decision to switch to active treatment.
The aim of active surveillance, which involves regular PSA tests, prostate exams, scans and repeat biopsies to monitor cancer growth, is to safely avoid unnecessary treatment and its associated side effects.
Active surveillance increased from 38 per cent of patients in 2008 to 69 per cent in 2014. However, on average, four years after diagnosis, 51 per cent of men on the study had discontinued active surveillance, mainly due to signs of tumour progression.
Younger patients and those with certain higher-risk characteristics, such as higher PSA levels and more positive (showing cancer cells) biopsies were more likely to switch to active treatment. However, 40 per cent of men who could have stayed on active opted for treatment.
The study’s lead author Dr Antonio Finelli believes the findings have important implications for management of low-risk prostate cancer, including setting realistic expectations for men considering their treatment options.
Dr Sarah Hsaio, Director of Biomedical Research and Impact at Movember, said: “The results of this study highlight the urgent need to develop more specific tests to more accurately determine which men would benefit from opting for active surveillance.”