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Men who skip aggressive prostate cancer treatment not following-up enough

Men often choose to avoid the side effects of treatment if they have low-risk cancer, however 95 percent of them are not being watched closely enough.

By Stephen Feller
Researchers said more work needs to be done to determine why doctors and patients choose surveillance over treatment, but that better guidelines should be established for patient follow-ups. Photo by Image Point Fr/Shutterstock
Researchers said more work needs to be done to determine why doctors and patients choose surveillance over treatment, but that better guidelines should be established for patient follow-ups. Photo by Image Point Fr/Shutterstock

LOS ANGELES, Dec. 1 (UPI) -- A large review of medical records reveals more than 95 percent of men with low-risk prostate cancer who choose active surveillance over aggressive treatment are not being as closely monitored as they should, researchers at the University of California Los Angeles report.

Many men choose to monitor their cancer when it is caught early or is growing slowly in order to avoid the side effects of surgery and radiation treatments, which can include erectile and urinary dysfunction.

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Active surveillance includes routine prostate-specific antigen, or PSA, testing and additional physical examinations and biopsies in order to properly monitor the cancer. For some reason, researchers said, this often does not happen.

"Many researchers have been advocating for active surveillance for men with low-risk disease," said Dr. Karim Chamie, surgical director of UCLA's bladder cancer program, in a press release. "However, this study suggests that before we advise our patients to pursue active surveillance for their prostate cancers, we should be certain that we are committed to closely monitoring the cancers with a repeat biopsy, PSA testing and physical exams."

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Using information from Medicare and the Surveillance, Epidemiology, and End Results, or SEER, study, researchers reviewed medical records for 37,687 men diagnosed with prostate cancer between 2004 and 2007, and were followed through 2009.

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The researchers identified 3,656 undergoing watchful waiting or active surveillance, finding that, compared to men receiving active treatment, the surveillance group was less likely to receive PSA tests or attend office visits within two years of diagnosis.

Chamie said there was statistically significant increase in follow-ups as time went on, however whether the longer time frame continued to see an increase in follow-up visits requires more research.

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"Active surveillance is underused, and there is uncertainty regarding the quality of surveillance for patients who undergo watchful waiting or active surveillance," researchers wrote in the study, which is published in the journal Cancer.

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