AUA 2017: Studies Highlight Shifts in Prostate Cancer Screening and Management

Key Points

  • Among 432 men younger than 60 under active surveillance protocols, 131 were ultimately treated (the majority due to pathologic progression, PSA progression, volume progression, or patient preference).
  • Researchers found high levels of satisfaction from patients for both biopsy discussion encounters and follow-up appointments carried out as part of active surveillance protocols conducted by video conference.
  • Researchers surveyed nearly 900 urologists, radiation oncologists, and medical oncologists to assess screening preferences and treatment recommendations. Of the 869 respondents, 90% (784) endorsed past or future screening for themselves or for relatives, with 61% (494) having undergone screening previously.

Active surveillance in men under 60, use of telemedicine in the management of prostate cancer, and physicians' personal prostate cancer screening preferences were all highlighted at the 2017 Annual Scientific Meeting of the American Urological Association (AUA).

Active Surveillance for Low-Risk Prostate Cancer in Men Under 60

In men with low-risk prostate cancer, the use of active surveillance is increasing; however, outcomes data relative to the use of active surveillance in men under 60 years old is limited. New data presented by Salari et al (Abstract PD55-03) indicate that active surveillance may be a reasonable option in carefully selected younger men.

Using data from Massachusetts General Hospital and Sunnybrook Health Sciences Centre, researchers analyzed clinical outcomes for 432 men on active surveillance protocols. Of this group, 131 patients were ultimately treated (the majority due to pathologic progression, prostate-specific antigen [PSA] progression, volume progression, or patient preference). Five patients developed metastasis. Metastasis-free survival was 99.7% at 5 years and 97.5% at 10 years. There were no prostate cancer–specific deaths.

Telemedicine in the Management of Prostate Cancer

The use of telemedicine to evaluate prostate cancer patients may be a viable option for some types of encounters, according to research presented by Glassman et al (Abstract PD09-01). Using data from patient satisfaction surveys administered following video-conferenced appointments, researchers in the Department of Urology at Sidney Kimmel Medical College in Philadelphia found high levels of satisfaction from patients for both biopsy discussion encounters and follow-up appointments carried out as part of active surveillance protocols. There was no significant difference in satisfaction among the appointment types.

Screening and Treatment Choices Among Physicians

Physicians who routinely treat prostate cancer are more likely to undergo PSA screening or recommend it to their immediate family, according to data presented by Wallis et al (Abstract PD07-07).

Researchers surveyed nearly 900 urologists, radiation oncologists, and medical oncologists to assess screening preferences and treatment recommendations. Of the 869 respondents, 90% (784) endorsed past or future screening for themselves or for relatives, with 61% (494) having undergone screening previously. Researchers also assessed urologists and radiation oncologists relative to recommended treatments for family members diagnosed with prostate cancer, finding a significant correlation between medical specialty and treatment selection.

Commentary

“Through these studies, we can see that the doctors who manage prostate cancer really do practice what they preach, and choose PSA screening for themselves. These studies also show how new technology and treatment options are providing today's patients with a wider variety of options and increasing patient satisfaction,” said Stacy Loeb, MD, Assistant Professor of Urology and Population Health at New York University. “We have made significant progress in the way that we screen and manage prostate cancer, and these advances will help the next generation of patients and physicians.”

The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.


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