Prostate cancer is the most common type of cancer in men, with a European incidence rate of 214 cases per 1000 men, numerical lung and colon cancer. Research shows that with advancing age, most men are likely to have a prostate cancer for many of the cancer are so grow slowly, that it does not, creates a real problem. Recently, there has been considerable public impact the risk of prostate cancer "over-diagnosis"-treatment, if it is not justified by a serious health threat.
Given the fact that the treatment for prostate cancer is either radiation therapy or major surgery, and that this gave significant side effects such as incontinence and impotence, there a rising trend to low-risk men under "active surveillance"; in other words, not the cancer immediately after surgery or radiation therapy to treat, but regularly monitoring of cancer, to determine whether it degrades. However, there were very few studies that show how this monitoring in real life.
Now a group of researchers from bathing in the Switzerland presented a long-term study of the European Association of Urology Congress in Stockholm that raises concerns in relation to the safety of the active monitoring. The study was based in a hospital with normal size rather than at an academic medical center, is so likely as prostate cancer follows in the real world. This study followed 157 patients over a period of time of when active monitoring. Required, after 13 years, that one (28%) of all patients that definitive treatment has been established. Almost all of these men were cured of cancer. But has also been found, that of an other (27%) of all patients do not show up to the recommended Termine--really is the main element of the active monitoring.
These men have no follow-up letters requesting current check-up, so be answered from the active surveillance system.
Lead researcher Dr. Lukas Hefermehl said "the limitation of this study is that this is no big, but nevertheless, it is one of the best" real "we have samples with long term data. I am convinced that active surveillance is a good choice for men who follow the recommended controls. But our results sees it needs a significant number of men lost to follow-up, which eventually develop a progressive disease; Many of these men can even eventually die from prostate cancer. As urologists we remain is still responsible for these patients."
The Group also found that 30 men (19%) refused a binding confirmation biopsy only 3 months after the initial diagnosis, a wrong interpretation of the first biopsy could have excluded.
Dr. Hefermehl went on: "we don't know what are exactly the reasons. It may be that as soon as the patient was told, that this cancer is probably "not imminent", he could be the other tests downplay. On the other hand some men may be real concerns about the risk of a serious cancer. There can be a feeling that it happened with the risk of incontinence or impotence after the treatment, the idea of having cancer, nothing really to them or it can be due to another reason that we not only know how to do."
But the fact is that overall you have these findings you us with a practical and ethical dilemma. often it is advisable, the men go on an active monitoring program, but these results show that more than a quarter of the men out of the system will disappear. We firmly believe that these "patients factor" for future active audit logs must be considered"
Said Professor Manfred Wirth (Dresden), Treasurer and Board Member, communication from the European Board of urology:
"This is very interesting and potentially controversial work, based on clinical practice in the real world. "It shows that we have a better understanding of the psychological factors can the kind of effective follow get on these points could."