American Veterans Prefer Active Surveillance of Prostate Cancer Over Therapy

A study conducted by researchers at NYU School of Medicine – Perlmutter Cancer Center, and by the VA NY Harbor Healthcare System – Manhattan campus shows that American veterans postpone cancer therapy in favor of active surveillance.

Patients diagnosed with a non-aggressive form of prostate cancer prefer to opt out of surgery or radiotherapy. The study shows a record number of cancer patients who prefer to keep an eye on their cancer rather than start immediate therapy.

What Does Active Surveillance Mean?

The program consists of regular check-ups, with blood tests, physical exams and sampling of the prostate tissue to check if the tumor starts to grow.

The study was published in the Journal of the American Medical Association (JAMA) on 15 May and it’s the first of its kind to review such a big record of medical data. Researchers analyzed medical records of 125,083 former servicemen. The majority of veterans are over 55 years old, and have been diagnosed with a low-risk prostate cancer between 2005-2015.

In that period, blood testing for prostate specific antigen (PSA) had overdiagnosed the disease. Many patients were treated for even the smallest prostate cancer that wouldn’t have caused death.

Active Surveillance Has Increased in the Last Decade

The results show that in 2005 only 27% men under 65 years old chose therapy and 4% chose active surveillance.

However, as time passed, in 2015, 72% declined immediate therapy and 39% chose active surveillance. The same numbers remained for men over 65. At older age, side effects of surgery or radiation can cause higher risks of side effects.

The study senior investigator and urologist Stacy Loeb, MD, MSc, states:

“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.”

Loeb adds that the reversal is “historic”. It has been more than a decade of overtreating prostate cancer in harmless cases. Now, the VA “brings their care more in line with the latest best practice guidelines.”

For the next step, researchers will look into how they can improve active surveillance rates though online educational materials.

Rex Austin

Rex Austinwas born and raised in Thunder Bay Ontario on the shores of Lake Superior. Apart from running his own podcast (Ice Fishing And Other “Cool” Things), he spends his time canoeing and backpacking in Northern Ontario.. As a journalist Rex has published stories for Global News (Thunder Bay) we well as Buzz Feed and Joystiq. As a contributor to Great Lakes Ledger, Rex most covers science and health stories. Contact Rexhere