PCPC3 is pleased to see the recently published report by Tosoian et al. indicating a 99.9% prostate cancer-specific survival rate at 10 and 15 years post-diagnosis in a cohort of > 1,200 patients initially managed on active surveillance at Johns Hopkins Medical Center.
This report provides further substantive evidence for first-line and long-term use of active surveillance as a highly appropriate management strategy for the majority of men initially diagnosed with low- and very low-risk prostate cancers. Such management is already recommended in the guidelines of the National Comprehensive Cancer Network and other organizations.
PCPC3 does, however, note that there are still outstanding questions as to whether active surveillance can be used with quite the same degree of confidence in men of African descent as appears to be the case in men of Caucasian and Hispanic ethnic origins.
Patients and advocates should also be aware that there are small differences in the definitions of “low-risk” and “very low-risk” prostate cancer used by different organizations — but all such patients must usually have a PSA level of less than 10 ng/ml, a clinical stage of T2a or lower, and a Gleason score of 3 + 3 = 6 or less. Patients in the Johns Hopkins cohort abovementioned were also required to have a PSA density of less than 0.15.
Prostate cancer patients should discuss the appropriateness of active surveillance with their doctor(s) based on their individual diagnosis and medical history.
PCPC3 — the patient-centered prostate cancer collaborative coalition — is a group of independent, not-for-profit, patient-centric organizations whose primary goals include the education and support of men diagnosed with prostate cancer, their family members and care-givers, and all men at risk for prostate cancer. For more information about PCPC3, please see the PCPC3 web site.