Thanks for providing the article, Tony.
It appears to me that the main point of the article was this (in my words): The “overtreatment” of low-risk PC is now well recognized in the medical community. While Active Surveillance is appropriate for the lowest risk patients, we need to further develop & improve some of the newer focal targeted therapies which might be more appropriate for treating some of the cases on the other lower-risk localized patients, because radical prostatectomy or radiation is largely overkill for those cases. Stereotactic body radiation therapy (SBRT, a 3-dimensional image-guided focal radiation) is one of the promising treatment options for the future.
Anyone else who read this article have a similar or different interpretation?
It’s a common theme which is being recognized by the leading experts in prostate cancer treatment…they recognize the current epidemic of PC overtreatment, they advocate AS where appropriate, and they support development of focal therapies for the non-AS low-risk cases. D’Amico (an RT expert) has made his statement here. I’ve also seen a presentation by Dr Peter Scardino (surgeon) where he outlines the appropriate treatments for low- and intermediate-risk PC patients in this way (I’ll just copy his presentation slide):
LOW RISK PC
- Restage with MRI, repeat biopsy to rule out higher risk cancer
- Active Surveillance
- Future: chemosuppression for diffuse cancers, and focal therapy for selected, localized cancers.
ALL OTHER CANCERS [intermediate-risk cancers] IN MEN WITH LIFE EXPECTANCY >10 YEARS LIFE EXPECTANCY
- RP or Radiotherapy
Scardino's message is similar to D-Amico's...the surgeon and the radiologist agree!
thanks again, Tony
edit: fixed typo