The
approach is called active surveillance. It means their cancers are left
alone but regularly monitored to be sure they are not growing. Just 10
percent to 15 percent of early-stage prostate cancer patients were being
treated by active surveillance several years ago. Now, national data
from three independent sources consistently finds that 40 percent to 50
percent of them are making that choice.
In
recent years, major research organizations have begun to recommend
active surveillance, which for years had been promoted mostly by
academic urologists in major medical centers, but not by urologists in
private practice, who treat most men. In 2011, the National Institutes of Health held a consensus conference
that concluded that it should be the preferred course for men with
small and innocuous-looking tumors. Last year, the American Society of
Clinical Oncology issued guidelines with the same advice. Preliminary 2016 data from the urology association indicates that the
numbers are growing, with even more than 50 percent of patients choosing
active surveillance.
Half of all men with newly diagnosed prostate cancer have low-risk
tumors, which pathologists, using a scoring system that looks at the
appearance of cells under a microscope, rate as Gleason 6 or less on a
commonly used scale. Their risk of dying from prostate cancer in the
next 10 years is less than 1 percent.
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