Breaking News
August 16, 2018 - Ablating the mutant p53 gene in mice with colorectal cancer inhibits tumor growth
August 16, 2018 - Higher BMI in people with prediabetes related to evening preference and lack of sufficient sleep
August 16, 2018 - Using peripheral nerve blocks to treat facial pain may produce long-term pain relief
August 16, 2018 - Neural stem cells are the key to tail regeneration
August 16, 2018 - Study compares genetic and neural contributions to ADHD in children with or without TBI
August 16, 2018 - Adding energy drinks to alcohol may exacerbate negative effects of binge drinking
August 16, 2018 - Eye Examination Can Help Detect Abuse in Children
August 16, 2018 - Know the Difference: Rheumatoid Arthritis or Osteoarthritis?
August 16, 2018 - From ‘sea of mutations,’ two possible cancer links rise to the surface
August 16, 2018 - Does medical school take too long?
August 16, 2018 - Brown University researchers reveal key physical properties of ‘giant’ cancer cells
August 16, 2018 - Regular resistance training improves exercise motivation
August 16, 2018 - Feds urge states to encourage cheaper plans off the exchanges
August 16, 2018 - Seven activities that prevent you from getting quality sleep during summer
August 16, 2018 - Five ways to tell if your baby is getting enough milk from breastfeeding
August 16, 2018 - From Pigs to Peacocks, What’s Up With Those ‘Emotional-Support Animals’?
August 16, 2018 - Breast cancers enlist the help of normal cells to help them spread and survive
August 16, 2018 - Engaging with “high-need” patients outside the clinic
August 16, 2018 - Research illuminates how online forum may offer suicide prevention support for males
August 16, 2018 - Researchers identify way to grow immune cells at large scale for preventing cancer reoccurrence
August 15, 2018 - Keck Medicine of USC’s hospitals ranked among nation’s best for the 10th consecutive year
August 15, 2018 - Researchers compare existing approaches for automating diagnostic procedures of skin lesions
August 15, 2018 - Autism risk determined by health of mom’s gut, research reveals
August 15, 2018 - WELL for Life challenges you to explore the great outdoors
August 15, 2018 - ‘Zombie’ gene protects elephants from cancer, study finds
August 15, 2018 - Ebola outbreak in Congo spreads to active combat zone
August 15, 2018 - Study highlights pollution exposure of babies in prams
August 15, 2018 - Study provides insight into link between sleep apnea and lipid metabolism
August 15, 2018 - New study focuses on promise of gene therapy for Amish nemaline myopathy
August 15, 2018 - Researchers discover new approach to alleviate chronic itch
August 15, 2018 - Uncovering the Mysteries of MS: Medical Imaging Helps NIH Researchers Understand the Tricky Disease
August 15, 2018 - Autistic people at greater risk of becoming homeless – new research
August 15, 2018 - New imaging technique can spot tuberculosis infection in an hour
August 15, 2018 - Scientists study effects of eating breakfast versus fasting overnight before exercise
August 15, 2018 - Talking with children about suicide could save lives
August 15, 2018 - Grip strength of children predicts future cardiometabolic health
August 15, 2018 - Innovative oncofertility program launched by RMA of New York and Mount Sinai Health System
August 15, 2018 - Study shows efficacy, safety of AAV5-based gene therapy to treat sheep model of achromatopsia
August 15, 2018 - Simple score helps predict which hospitalized heart attack patients are at high risk of readmissions
August 15, 2018 - New discoveries show how protein droplets do more than keep cells’ interiors tidy
August 15, 2018 - Study shows impact of optimizing airport flight patterns on human health
August 15, 2018 - Life experiences of feeling unwanted or unplanned associated with attachment insecurity
August 15, 2018 - ACS Briefing Discusses Use of Lessons From Combat Care
August 15, 2018 - Study identifies distinct origin of ADHD in children with history of brain injury
August 15, 2018 - IgG3 antibody stops B cells from fighting pathogens in HIV patients
August 15, 2018 - Scientists discover key vulnerability of mixed lineage leukemia
August 15, 2018 - College students may experience pressures from secondary exposure to opioid abuse
August 15, 2018 - Powerful new microscope reveals inner workings of human cells with unprecedented clarity
August 15, 2018 - Married people who fight nastily more likely to suffer from leaky guts, study suggests
August 15, 2018 - Working Out After Baby – Drugs.com MedNews
August 15, 2018 - Rheumatoid Factor (RF) Test: MedlinePlus Lab Test Information
August 15, 2018 - ADHD linked to an increased risk of injury in children, study finds
August 15, 2018 - UIC researchers receive NIH funding to develop a better way to regenerate bone or tissues
August 15, 2018 - Study reveals how immune cells in the brain influence sexual behavior
August 15, 2018 - Researchers move closer to finding potential soft spot in drug-resistant tuberculosis
August 15, 2018 - Real-time dynamic monitoring of cell’s nucleus for effective cancer screening
August 15, 2018 - Lower rates of Medicare preventive care visits found in racial, ethnic minority older adults
August 15, 2018 - Scientists identify stress hormone as key factor in failure of immune system to inhibit leukemia
August 15, 2018 - Cytoplan introduces three new nutritional supplements
August 15, 2018 - Effective hemorrhage control critical for survival after motorsport accidents
August 15, 2018 - Sygnature Discovery announces ambitious expansion plan with addition of Alderley Park facility
August 15, 2018 - Dietary carbohydrates could lead to osteoarthritis, new study finds
August 15, 2018 - Male tobacco smokers have decreased number of cannabinoid CB1 receptors, study reveals
August 15, 2018 - Scientists explore ways for drug therapies to reach deadly brain tumors
August 15, 2018 - Rethinking fundamental rule of stroke care: ‘Time is brain!’
August 15, 2018 - Scientists reveal role of ‘junk DNA’ in cancer dissemination
August 15, 2018 - Google’s DeepMind AI could soon be diagnosing eye conditions
August 15, 2018 - Scientists trick the brain to embody the prosthetic limb
August 15, 2018 - Researchers focus on uncoupling obesity from diabetes
August 15, 2018 - Clinical study shows how EarlySense system effectively detects opioid-induced respiratory depression
August 15, 2018 - A class of proteins shown to be effective in reducing drug-seeking behaviors
August 15, 2018 - FundamentalVR launches first-of-its-kind SaaS software platform for surgical simulation
August 15, 2018 - Gemphire Announces Termination of Phase 2a Clinical Trial of Gemcabene in Pediatric NAFLD
August 15, 2018 - Rheumatoid arthritis in pregnancy associated with low birth weight and premature birth
August 15, 2018 - Study may help increase effectiveness of antibiotics against drug-resistant bacteria
August 15, 2018 - Analyzing resident-to-resident incidents in dementia may hold the key to reducing future fatalities
August 15, 2018 - Robotic walking frame aims to help maintain mobility of older adults
August 15, 2018 - Simple intervention during routine care reduces alcohol consumption in men with HIV
August 15, 2018 - Genetics Home Reference: gout
August 15, 2018 - Scientists ID genesis of disease, focus efforts on shape-shifting tau
Many prostate cancer patients choose active surveillance over immediate therapy

Many prostate cancer patients choose active surveillance over immediate therapy

image_pdfDownload PDFimage_print

Record numbers of American veterans diagnosed with non-aggressive prostate cancer are heeding the advice of international medical experts and opting out of immediate surgery or radiation to treat their cancer.

Instead, according to a study led by researchers at NYU School of Medicine, its Perlmutter Cancer Center, and the Manhattan campus of the VA NY Harbor Healthcare System, increasing numbers of these men are electing to postpone additional therapy unless their symptoms worsen -; a passive practice called watchful waiting -; or they are choosing so-called active surveillance. This program relies on regular check-ups, including blood tests, physical exams, and the occasional needle sampling of prostate tissue to check for any signs of a tumor getting worse, such as fast growth, before aggressive treatment is considered.

The new study, summarized in the Journal of the American Medical Association (JAMA) online May 15, is one of the largest studies of its kind, involving a review of the medical records of 125,083 former servicemen, mostly over the age of 55, who were newly diagnosed with low-risk prostate cancer between 2005 and 2015.

It was during this time, researchers say, that widespread use of blood testing for prostate specific antigen (PSA) was roundly criticized for overdiagnosing the disease and leading to the treatment of the smallest, non-aggressive prostate cancers, highly unlikely to cause death.

Using data collected from the VA’s Central Data Warehouse, researchers found that in 2005, only 27 percent of men under age 65 chose to forego immediate therapy, and just 4 percent chose active surveillance.

By contrast, in 2015, some 72 percent passed on immediate therapy, with 39 percent choosing active surveillance. Similar numbers were observed for study participants who were over age 65 and known to be less likely to pursue surgery or radiation, which carry a higher risk of side effects, such as bowel and bladder problems, as well as sexual dysfunction.

“Our study shows that the Veterans Affairs health care system has done a good job over the last decade in adopting ‘conservative management’ of men diagnosed with early-stage disease, with many men choosing active surveillance as an alternative to immediate therapy,” says study senior investigator and urologist Stacy Loeb, MD, MSc.

“This marks a historic reversal, at least at the VA, in the decades-long overtreatment of men with prostate cancers least likely to cause harm, and brings their care more in line with the latest best practice guidelines,” says Loeb, citing a 2016 report from the American Society of Clinical Oncology, which discourages aggressive therapy for low-grade tumors.

Loeb, an assistant professor in the urology and population health departments at NYU School of Medicine and an attending urologist at VA New York Harbor Healthcare System, says the VA’s success raises its standard of care of low-risk prostate cancer to levels seen in other countries like Sweden, where active surveillance rates top 70 percent. And it offers hope, she says, for many private clinics in the United States, which lag behind with as many as two-thirds of men at low risk undergoing early aggressive treatment, according to published estimates.

Loeb cautions that some men may opt for immediate treatment with “sound concerns” rather than active surveillance, especially men who had an infection after their initial biopsy, and fear it happening again with any further procedures. What is important, Loeb explains, is that patients and their physicians carefully review options after a diagnosis and that the risks of immediate treatment are understood when a “shared decision” is made.

Loeb credits the VA’s success to several factors, noting that it is part of a national network of publicly funded hospitals, where many physicians are salaried, so there is little financial incentive to overtreat.

“The main conclusion to be drawn from the data is that if so many veterans can quickly adopt this less-risky disease-management strategy, then so too might other American men if they understood the potential benefits of this option,” says Loeb.

Loeb says her team, in conjunction with the Prostate Cancer Foundation, which helped fund the current study, next plans to look at ways, such as use of online educational materials, to improve active surveillance rates.

The U.S. National Cancer Institute estimated that 26,000 American men would die from prostate cancer in 2017, with 161,000 new cases diagnosed, most in its earliest stages.

Source:

https://nyulangone.org/press-releases/va-healthcare-system-successfully-reduces-rush-to-treatment-rates-for-low-risk-prostate-cancer-study-shows

Tagged with:

About author

Related Articles