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Men Don’t Follow the Rules For Active Surveilance of Prostate Cancer

You Don’t Want to Lose the Opportunity to Treat the Cancer

Like many other diseases, prostate cancer, the most common cancer among men and the second most common cause of cancer-related deaths among men in this country, is especially hard on our men. In fact, black men are more likely to get prostate cancer and twice as likely to die from the disease.

Despite these statistics, new research suggests men diagnosed with early-stage prostate cancer are neglecting guidelines to monitor their condition.

A study of almost 350 North Carolina residents found only 15 percent who chose active surveillance followed the recommended guidelines.

To be fair, these guidelines are rigorous, calling for PSA tests every six months, an annual digital rectal exam and a prostate biopsy within 18 months of diagnosis. This is “so you can watch the cancer very closely,” said study co-author Ronald Chen, an associate professor from the University of North Carolina Lineberger Comprehensive Cancer Center in Chapel Hill. “You don’t [want to] lose the opportunity to treat the cancer when it starts to grow.”

Among the study’s participants, 67 percent had a PSA test within six months of their diagnosis and 70 percent had a digital rectal exam. Only 35 percent had the biopsy during the first 18 months. Over a two-year period, a paltry 15 percent had undergone all the recommended tests.

The reasons why so few men followed the guidelines weren’t clear to researchers, who found no connection with age, income or race.

“This raises the question of whether we need to investigate whether active surveillance is a safe option when patients do not receive routine monitoring,” Chen said. “Our goal is not to reduce the number of patients choosing active surveillance; rather, the results of this study should increase awareness and efforts to ensure that active surveillance patients are monitored rigorously.”

Chen and his team also looked into why men would or wouldn’t choose active surveillance. They found that as their cancer began to progress, men opted for treatment. And men who were anxious about their cancer were more likely to stop active surveillance and switch to treatment.


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