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Active Surveillance for Prostate Cancer

Active Surveillance for Prostate Cancer Editorials represent the opinions EDITORIAL of the authors and JAMA and not those of the American Medical Association. Against this backdrop, an increasing number of reports Ian M. Thompson, MD have chronicled the outcomes of surveillance for these pa- Laurence Klotz, MD tients. Active surveillance with treatment reserved for evi- dence of rapid PSA progression or increase in tumor vol- INCE 1980, THE PROGNOSIS OF PROSTATE CANCER ume or grade is associated with about a 3% risk of prostate has changed markedly as the United States has cancer death at 10 years. Clinical trials are currently ex- moved through 3 eras. The first era reflected the amining the benefit of treatment vs surveillance in prostate Sexperience of the prior century. Because prostate cancer. cancer is usually asymptomatic until it is metastatic and The appeal of active surveillance is both the desire to rectal examination has a low sensitivity for early cancer avoid overtreatment and the concern about how treat- detection, most men had advanced and incurable disease ment affects quality of life. The article by Hayes and col- at diagnosis. During the second era in the mid-1980s, leagues in this issue of JAMA is an important contribu- with the http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png JAMA American Medical Association

Active Surveillance for Prostate Cancer

JAMA , Volume 304 (21) – Dec 1, 2010

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Publisher
American Medical Association
Copyright
Copyright 2010 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.
ISSN
0098-7484
eISSN
1538-3598
DOI
10.1001/jama.2010.1761
pmid
21119090
Publisher site
See Article on Publisher Site

Abstract

Editorials represent the opinions EDITORIAL of the authors and JAMA and not those of the American Medical Association. Against this backdrop, an increasing number of reports Ian M. Thompson, MD have chronicled the outcomes of surveillance for these pa- Laurence Klotz, MD tients. Active surveillance with treatment reserved for evi- dence of rapid PSA progression or increase in tumor vol- INCE 1980, THE PROGNOSIS OF PROSTATE CANCER ume or grade is associated with about a 3% risk of prostate has changed markedly as the United States has cancer death at 10 years. Clinical trials are currently ex- moved through 3 eras. The first era reflected the amining the benefit of treatment vs surveillance in prostate Sexperience of the prior century. Because prostate cancer. cancer is usually asymptomatic until it is metastatic and The appeal of active surveillance is both the desire to rectal examination has a low sensitivity for early cancer avoid overtreatment and the concern about how treat- detection, most men had advanced and incurable disease ment affects quality of life. The article by Hayes and col- at diagnosis. During the second era in the mid-1980s, leagues in this issue of JAMA is an important contribu- with the

Journal

JAMAAmerican Medical Association

Published: Dec 1, 2010

References