In a new study, researchers found that men who choose active surveillance to manage early prostate cancer often don’t follow the monitoring rules.
They found that just about 15% of a group of men with early-stage prostate cancer who choose active surveillance followed the recommended monitoring guidelines.
The research was conducted by a team from the University of North Carolina.
Active surveillance for prostate cancer has rigorous guidelines. People need regular prostate-specific antigen (PSA) tests, prostate exams, and prostate biopsies to watch cancer very closely.
In this way, patients don’t lose the opportunity to treat cancer when it starts to grow.
In the study, the team ran an analysis of 346 men newly diagnosed with low or intermediate-risk prostate cancer in North Carolina.
The active surveillance recommended PSA tests at least every six months, digital rectal exams annually, and a repeat biopsy within 18 months of diagnosis.
The team analyzed how often men received biopsies and other tests according to the guidelines from the National Comprehensive Cancer Network.
They found that only 15% of patients in active surveillance followed recommended monitoring.
In the first six months, 67% of patients had received a PSA test, and 70% received a digital rectal exam. Just 35% received a biopsy within the first 18 months.
Across all types of tests by 24 months, only 15% of patients received monitoring compliant with the guidelines.
The finding shows that very few patients who elected to undergo active surveillance actually received the recommended monitoring.
This raises the question of whether active surveillance is a safe option when patients do not receive routine monitoring.
The team hopes the results of this study could increase awareness and efforts to ensure that active surveillance patients are monitored rigorously.
The team also found that a patient’s level of anxiety was linked to whether or not they stopped active surveillance and switched to treatment.
Anxiety may be one of the reasons why people have the treatment and stop active surveillance.
The leader of the study is Ronald C. Chen, MD, MPH, associate professor in the UNC School of Medicine Department of Radiation Oncology.
The study was presented at the American Society of Clinical Oncology Annual Meeting 2019.
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