SC Connecticut News

Prostate cancer remains a prevalent concern for men, being the second most commonly diagnosed cancer after skin cancer and the second leading cause of cancer death following lung cancer. A recent study by researchers at Yale Cancer Center has highlighted an increasing trend in adopting active surveillance (AS) and watchful waiting (WW) as treatment strategies for early-stage prostate cancer. This approach involves close monitoring of the condition with regular tests and examinations, allowing patients to delay aggressive treatments while retaining the option to intervene if necessary.

Dr. Michael Leapman, senior author of the study and clinical program leader at Yale Cancer Center, explained that managing localized prostate cancer poses challenges in assessing individual risk. "We know that many prostate cancers will not spread or cause symptoms if untreated," said Leapman. Over the past decade, there has been a notable shift towards initial monitoring for low-risk cancers. The study aimed to determine whether this conservative management approach is also increasing among intermediate-risk cases.

The research utilized data from the Surveillance, Epidemiology, and End Results (SEER) program, which gathers information on various cancers across the U.S. It focused on individuals diagnosed with intermediate-risk prostate cancer based on criteria such as Gleason grade, PSA levels, and cancer stage.

Findings revealed a rise in intermediate-risk prostate cancer diagnoses over time, with more patients opting for AS/WW instead of immediate treatment. From 2010 to 2020, those choosing AS/WW increased from 5% to 12.3%, indicating a preference for conservative management among this group.

Leapman noted these findings indicate growing interest in monitoring early-stage prostate cancers: "This is important progress in reducing the over-treatment of incidentally detected prostate cancers posing relatively low risks to patients." However, he emphasized questions remain regarding long-term outcomes and utilizing new tools to personalize patient decisions further.

With less-aggressive forms of cancer increasingly managed through AS/WW due to favorable long-term outcomes evidence, this research underscores personalized care importance. It highlights individualized treatment plans considering specific characteristics and personal preferences.

The authors advocate national efforts toward standardizing AS/WW quality monitoring while encouraging future research into refining criteria for initiating or discontinuing such approaches using biological markers where applicable.

Ismaiil Ajjawi from Yale School of Medicine served as first author alongside Cary Gross and Xiaomei Ma as co-authors on this study published in JAMA on November 20.