The very NIH panel wrote in their conclusions:
Prostate cancer screening with PSA testing has identified many men with low-risk disease. Because of the very favorable prognosis of low-risk prostate cancer, strong consideration should be given to modifying the anxiety-provoking term “cancer” for this condition.
Treatment of low-risk prostate cancer patients with radical prostatectomy or radiation therapy leads to side effects such as impotence and incontinence in a substantial number. Active surveillance has emerged as a viable option that should be offered to patients with low-risk prostate cancer.
More than 100,000 men a year diagnosed with prostate cancer in the United States are candidates for this approach. However, there are many unanswered questions about
active surveillance strategies and prostate cancer that require further research and clarification. These include:
• Improvements in the accuracy and consistency of pathologic diagnosis of prostate cancer
• Consensus on which men are the most appropriate candidates for active surveillance
• The optimal protocol for active surveillance and the potential for individualizing the approach based on clinical and patient factors
• Optimal ways to communicate the option of active surveillance to patients
• Methods to assist patient decisionmaking
• Reasons for acceptance or rejection of active surveillance as a treatment strategy
• Short- and long-term outcomes of active surveillance.
Well-designed studies to address these questions and others raised in this statement represent an important health research priority. Qualitative, observational, and interventional research designs are needed. Due to the paucity of evidence about
this important public health problem, all patients being considered for active surveillance should be offered participation in multicenter research studies that incorporate community settings and partners."
As you can see, this is far from a national consensus pending results from those proposed studies.
I have been living with prostate cancer since 1992. The views or opinions expressed here are my own and are not endorsed nor supported by any agency or institution. Ask your physician for medical advice.
DX at age 58. RP; Orchiectomy; GS (4 + 2); bilateral seminal vesicle invasion; tumor attached to rectal wall; Stage T4; Last PSA July, 0'11: <0.1 www.pcainaz.org