Health: three-quarters of men with small-growing prostate cancers not properly monitored

Research published online by the Medical Journal of Australia has found almost three quarters of men diagnosed with “low risk” prostate cancer are not being followed up in compliance with the active surveillance protocol developed to detect signs of disease progression.

Associate Professor Sue Evans, Head of the Clinical Registry Unit, and Director of the Centre of Research Excellence in Patient Safety at Monash University says ““It is generally accepted, however, that the first follow-up biopsy should be undertaken within 12 months of diagnosis; the recommended timing of subsequent biopsies ranges from annually to once every 5 years.”

Associate Professor Sue Evans highlighted that the objectives of active surveillance are to avoid unnecessary treatment, but also to monitor men with low risk cancer according to a protocol that “facilitates recognition of progression which justifies deferred radical treatment with curative intent”.

The reasons for the non-compliance “may reflect patient-, clinician-, and health service-related factors”, the authors wrote.

“If they are not being followed appropriately according to active surveillance protocols, men may miss the opportunity to be treated with curative intent.”

“To improve adherence, a multifaceted approach may be required, including an education campaign that highlights the need for men to undergo regular PSA assessment and prostate biopsy,” they concluded.” Stated Associate Professor Sue Evans.

Prostate cancer is the most common cancer diagnosed in men in Australia and the third most common cause of cancer death. One in 6 men will be diagnosed with prostate cancer by the age of 85. It is more common in older men, with 63% of cases diagnosed in men over 65 years of age.