Active surveillance in Gleason 7 intermediate risk prostate cancer: is it safe?

Vol. 42 (3): 413-417, May – June, 2016

doi: 10.1590/S1677-5538.IBJU.2016.03.03


DIFFERENCE OF OPINION

Active surveillance in Gleason 7 intermediate risk prostate cancer: is it safe?
Opinion: Yes

Henk G. van der Poel 1, Roderick C.N. van den Bergh 2

1 Department of Urology, Netherland Cancer Institute, Amsterdam, The Netherlands; 2 Department of Urology, Royal Melbourne Hospital/Peter MacCallum Cancer Centre, Melbourne, Australia


Keywords: Prostatic Neoplasms; Prostate cancer, familial [Supplementary Concept]; Watchful Waiting; Disease; Therapeutics


Most men with prostate cancer will not die from it. Although the most frequent cancer in men in the western world it ranks only 3rd place for cause of death (1). In men over 60 years of age prostate cancer is found at autopsy in over 60% (2). Overdiagnosis by PSA screening is estimated to be 57% when screened until 75 years of age (3). Considering treatment toxicity, careful selection of men for treatment is essential. A shift towards more conservative management is apparent in larger registries (4, 5).

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