A more effective approach to prostate cancer treatment

April 29, 2014, McGill University

(Medical Xpress)—Active surveillance of men with low-risk prostate cancer may be better for quality of life and is cost-effective compared with immediate treatment, reports a study published today in CMAJ Open.

Prostate cancer is the most common cancer in Canadian men and the third leading cause of death from cancer. The incidence of , and associated economic costs, has increased 50% over the last three decades, although most cases are low to intermediate risk. Many cancers, despite being low-risk of progressing, are treated and overtreatment can affect patient quality of life.

"Despite published guideline recommendations, overtreatment of prostate cancer is common in the US and elsewhere, with approximately 70% to 90% undergoing active treatments," writes lead author Dr. Alice Dragomir from the Research Institute of the McGill University Health Centre (RI-MUHC) and assistant professor in the Department of Surgery, Division of Urology at McGill University, Montreal, Quebec. "In Canada, approximately 75% of patients with prostate cancer have received active treatment from 1995 through 2002. It is believed today that more than half of these patients did not require active treatment at the time of diagnosis but they incurred cost and morbidity."

Researchers developed a model to estimate cancer costs for – watching and waiting to see if cancer progresses – and immediate treatment of patients in Quebec, Canada. They found that active surveillance with follow up over 5 years could save approximately $96 million at the national level as the high-cost of treating cancer that was at low-risk of progressing could be avoided. With active surveillance, the cost per patient for the first year and the subsequent 5 years of follow up was estimated at $6 200 compared with $13, 735 for immediate treatment.

"Our study demonstrates that for eligible , active surveillance could offer not only the known clinical advantages from the patient's perspective, but also economic benefits from the health care system perspective," adds senior author Dr. Armen Aprikian, MUHC Chief of Oncology and head of the Division of Urology at McGill University

"The results of our study add to the economic rationale advocating active surveillance for eligible men with low-risk prostate cancer and highlights cost savings estimates specific to the Canadian public system," the authors conclude.

Explore further: Study finds prostate cancer tests underestimate disease in half of cases

More information: Alice Dragomir, Fabio L. Cury, and Armen G. Aprikian. "Active surveillance for low-risk prostate cancer compared with immediate treatment: a Canadian cost comparison." CMAJ Open 2:E60-E68; published online April 24, 2014, DOI: 10.9778/cmajo.20130037

Related Stories

Study finds prostate cancer tests underestimate disease in half of cases

April 11, 2014
A study published in the British Journal of Cancer suggests that tests to grade and stage prostate cancer underestimated the severity of the disease in half of men whose cancers had been classified as 'slow growing'.

Active surveillance cost-effective for prostate cancer

July 13, 2012
(HealthDay) -- In a theoretical cohort of 120,000 men, selecting active surveillance for prostate cancer results in considerable cost savings at five and 10 years of follow-up, compared with immediate treatment, according ...

Quarter of prostate cancer patients may abandon 'watchful waiting' approach

April 17, 2014
(HealthDay)—Doctors often recommend no treatment at all when a man is diagnosed with prostate cancer, opting instead to keep a close eye on the slow-growing tumor and acting only when it becomes aggressive.

Implications of very low risk prostate cancer assessed

September 20, 2013
(HealthDay)—The risk of adverse findings at surgery for men with very low risk (VLR) prostate cancer is significantly lower than for those with low risk (LR), according to research published in the October issue of the ...

Model confirms active surveillance as viable option for men with low-risk prostate cancer

September 24, 2012
A new research model has estimated that the difference in prostate cancer mortality among men with low-risk disease who choose active surveillance versus those who choose immediate treatment with radical prostatectomy is ...

Added prostate CA criteria may help ID surveillance candidates

January 24, 2014
(HealthDay)—Additional predictors, such as prostate-specific antigen (PSA) density and extent of cancer on biopsy, help guide selection of prostate cancer patients for active surveillance programs, according to research ...

Recommended for you

Single blood test screens for eight cancer types

January 18, 2018
Johns Hopkins Kimmel Cancer Center researchers developed a single blood test that screens for eight common cancer types and helps identify the location of the cancer.

Researchers find a way to 'starve' cancer

January 18, 2018
Researchers at Vanderbilt University Medical Center (VUMC) have demonstrated for the first time that it is possible to starve a tumor and stop its growth with a newly discovered small compound that blocks uptake of the vital ...

How cancer metastasis happens: Researchers reveal a key mechanism

January 18, 2018
Cancer metastasis, the migration of cells from a primary tumor to form distant tumors in the body, can be triggered by a chronic leakage of DNA within tumor cells, according to a team led by Weill Cornell Medicine and Memorial ...

Modular gene enhancer promotes leukemia and regulates effectiveness of chemotherapy

January 18, 2018
Every day, billions of new blood cells are generated in the bone marrow. The gene Myc is known to play an important role in this process, and is also known to play a role in cancer. Scientists from the German Cancer Research ...

These foods may up your odds for colon cancer

January 18, 2018
(HealthDay)—Chowing down on red meat, white bread and sugar-laden drinks might increase your long-term risk of colon cancer, a new study suggests.

The pill lowers ovarian cancer risk, even for smokers

January 18, 2018
(HealthDay)—It's known that use of the birth control pill is tied to lower odds for ovarian cancer, but new research shows the benefit extends to smokers or women who are obese.


Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.