Counterpoint: The Case for Immediate Active Treatment

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  • a From the Department of Urology, Georgetown University School of Medicine, Washington, DC, and the Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, Illinois.

Active monitoring strategies recently have received attention as possible treatment options for men with low-risk prostate cancer who have a life expectancy of more than 10 years. However, no current criteria sufficiently predict outcomes for individuals with clinically localized disease and an otherwise long life expectancy who undergo either immediate or delayed treatment, or no treatment. This article describes the available evidence regarding treatment outcomes in men with low-risk prostate cancer and presents the case for immediate active treatment.

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Correspondence: William J. Catalona, MD, 675 North Saint Clair Street, Suite 20–150, Chicago, IL 60611. E-mail: wcatalona@nmff.org
  • 1.

    American Cancer Society. Cancer Facts and Figures 2007. Available at: http://www.cancer.org/downloads/STT/CAFF2007PWSecured.pdf. Accessed January 28, 2007.

    • Search Google Scholar
    • Export Citation
  • 2.

    National Cancer Institute. Surveillance, Epidemiology, and End Results (SEER) Program. SEER*Stat Database: Incidence - SEER 17 Regs Public-Use, Nov 2005 Sub (1973-2003 varying), National Cancer Institute, DCCPS, Surveillance Research Program, Cancer Statistics Branch, released April 2006, based on the November 2005 submission. Available at: www.seer.cancer.gov. Accessed August 28, 2006.

    • Search Google Scholar
    • Export Citation
  • 3.

    Oberaigner W, Horninger W, Klocker H. Reduction in prostate cancer mortality in Tyrol, Austria, after introduction of prostate-specific antigen testing. Am J Epidemiol 2006;164:376384.

    • Search Google Scholar
    • Export Citation
  • 4.

    Freedland SJ, Kane CJ, Amling CL. Delay of radical prostatectomy and risk of biochemical progression in men with low risk prostate cancer. J Urol 2006;175:12981302; discussion 1302–1293.

    • Search Google Scholar
    • Export Citation
  • 5.

    Choo R, Klotz L, Danjoux C. Feasibility study: watchful waiting for localized low to intermediate grade prostate carcinoma with selective delayed intervention based on prostate specific antigen, histological and/or clinical progression. J Urol 2002;167:16641669.

    • Search Google Scholar
    • Export Citation
  • 6.

    Klotz L. Active surveillance for prostate cancer: for whom? J Clin Oncol 2005;23:81658169.

  • 7.

    Carter HB, Walsh PC, Landis P, Epstein JI. Expectant management of nonpalpable prostate cancer with curative intent: preliminary results. J Urol 2002;167:12311234.

    • Search Google Scholar
    • Export Citation
  • 8.

    Warlick C, Trock BJ, Landis P. Delayed versus immediate surgical intervention and prostate cancer outcome. J Natl Cancer Inst 2006;98:355357.

    • Search Google Scholar
    • Export Citation
  • 9.

    Miller DC, Gruber SB, Hollenbeck BK. Incidence of initial local therapy among men with lower-risk prostate cancer in the United States. J Natl Cancer Inst 2006;98:11341141.

    • Search Google Scholar
    • Export Citation
  • 10.

    Loeb S, Gonzalez CM, Roehl KA. Pathological characteristics of prostate cancer detected through prostate specific antigen based screening. J Urol 2006;175:902906.

    • Search Google Scholar
    • Export Citation
  • 11.

    Ohori M, Wheeler TM, Dunn JK. The pathological features and prognosis of prostate cancer detectable with current diagnostic tests. J Urol 1994;152:17141720.

    • Search Google Scholar
    • Export Citation
  • 12.

    Epstein JI, Walsh PC, Carmichael M, Brendler CB. Pathologic and clinical findings to predict tumor extent of nonpalpable (stage T1c) prostate cancer. JAMA 1994;271:368374.

    • Search Google Scholar
    • Export Citation
  • 13.

    Bastian PJ, Mangold LA, Epstein JI, Partin AW. Characteristics of insignificant clinical T1c prostate tumors. A contemporary analysis. Cancer 2004;101:20012005.

    • Search Google Scholar
    • Export Citation
  • 14.

    Bill-Axelson A, Holmberg L, Ruutu M. Radical prostatectomy versus watchful waiting in early prostate cancer. N Engl J Med 2005;352:19771984.

    • Search Google Scholar
    • Export Citation
  • 15.

    Wong YN, Mitra N, Hudes G. Survival associated with treatment vs observation of localized prostate cancer in elderly men. JAMA 2006;296:26832693.

    • Search Google Scholar
    • Export Citation
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