About 240,000 American men are diagnosed with prostate cancer each year, and in 130,000 the tumors are “localized and low-risk.” About 90 percent of the low-risk group now opt for curative treatment, but all are candidates for strategies based simply on following the patient closely, the panel said.
“Our panel found that men with localized and low-risk prostate cancer should be closely monitored, permitting their treatment to be delayed until warranted by disease progression,” Patricia A. Ganz, a physician at the University of California at Los Angeles who headed the 14-member committee, told reporters Wednesday.
She said she expected the conclusions to be both controversial and influential.
“An NIH-vetted document that describes this as a reasonable approach . . . can be very powerful,” she told reporters.
The committee’s carefully worded 19-page statement is the second blow this season to American medicine’s approach to the most common cancer in men. In October, a different panel that advises the government on disease prevention said most men should not be screened for prostate cancer with the PSA blood test because finding the disease early leads to no clear benefit.
The latest panel only considered what is known about management of tumors confined to the prostate gland that also appear relatively normal when viewed under a microscope. It did not discuss treatment of fast-growing, wildly abnormal cancers.
Its conclusions appeared to be generally, but not universally, supported by people who attended the conference, where researchers and practitioners Monday and Tuesday presented data about the “state of the science” of low-risk prostate cancer treatment .
“I think they did a wonderful job,” said Otis W. Brawley, chief medical officer of the American Cancer Society. “I’m hopeful this document will cause doctors and patients to consider ‘active surveillance’ as a legitimate treatment for this disease.”
Jerry Sims, a 72-year-old patient advocate who traveled from Pinckney, Mich., to attend the conference, called the panel’s work “a big step forward.” Eight years ago, he had a radical prostatectomy — treatment he thinks he embraced too quickly.
“In most places you can’t get married without waiting a few days. I don’t understand why there isn’t a cooling-off period for this disease,” he said.
However, Merel Grey Nissenberg, a San Diego malpractice lawyer who heads the California Prostate Cancer Coalition, said she was not entirely happy.
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