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When no treatment is the best treatment: Active surveillance strategies for low risk prostate cancers

Stavrinides, V; Parker, CC; Moore, CM; (2017) When no treatment is the best treatment: Active surveillance strategies for low risk prostate cancers. Cancer Treatment Reviews , 58 pp. 14-21. 10.1016/j.ctrv.2017.05.004. Green open access

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Abstract

Although the incidence of prostate cancer is rising due to PSA screening and increased life expectancy, the metastatic potential of low-grade, organ-confined disease remains low. An increasing number of studies suggest that radical treatment in such cases confers little or no survival benefit at a significant cost to morbidity. Active surveillance is a promising management approach of such low-risk cancers: eligible patients are selected based on clinical and pathological findings at diagnosis and are regularly monitored with digital rectal examinations, PSA testing and biopsies. Treatment, however, is deferred until and unless there is evidence of disease progression. This is a key difference from watchful waiting, where treatment is avoided until and unless there are symptoms. The purpose of this work is to review the rationale and evidence behind active surveillance and to offer an overview of current active surveillance strategies and outcomes.

Type: Article
Title: When no treatment is the best treatment: Active surveillance strategies for low risk prostate cancers
Location: Netherlands
Open access status: An open access version is available from UCL Discovery
DOI: 10.1016/j.ctrv.2017.05.004
Publisher version: http://doi.org/10.1016/j.ctrv.2017.05.004
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: Active surveillance, Clinically significant cancer, Magnetic resonance imaging, Prostate cancer, Reclassification
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Surgery and Interventional Sci
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Surgery and Interventional Sci > Department of Targeted Intervention
URI: https://discovery.ucl.ac.uk/id/eprint/1559716
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