Newswise — SEATTLE – May 30, 2024 – Researchers from Fred Hutch Cancer Center have found that active surveillance for prostate cancer patients with a low risk of progression is an effective alternative to immediate surgery or radiation to manage the disease.

Published in JAMA, the study found that 10 years after diagnosis, 49% of men using active surveillance – which includes regular prostate-specific antigen (PSA) testing, biopsies and digital-rectal exams to monitor whether the cancer is growing or becoming more aggressive – remained free of treatment or progression. Less than 2% developed metastatic disease and less than 1% died of prostate cancer.

Further, patients who were treated after several years of active surveillance had the same rates of poor outcomes, such as adverse pathology or metastasis, as those treated immediately following a confirmatory biopsy, validating active surveillance as a safe initial management strategy for low-risk prostate cancers.

The research is part of the Canary Prostate Active Surveillance Study (CanaryPASS), which collects data and tissue samples from more than 2,300 patients with early-stage prostate cancer. Researchers use the CanaryPASS data to better distinguish between low-risk and aggressive prostate cancers, develop biomarkers that can help with early detection and reduce overtreatment.

“The goal of active surveillance for prostate cancer is to reduce unnecessary treatments and side effects among those diagnosed with lower risk cancer while avoiding undertreatment of aggressive disease,” said Daniel Lin, MD, prostate cancer researcher and professor of urology at Fred Hutch and UW Medicine, and principal investigator of CanaryPASS. “We hope this study encourages a national acceptance of active surveillance as an effective management strategy for prostate cancer.”

According to the American Cancer Society, 1 in 8 men will be diagnosed with prostate cancer. If detected early, prostate cancer is highly treatable and most men survive. More than 30% of patients have slow-growing prostate cancer and may not benefit from invasive treatments that can cause debilitating side effects such as urinary incontinence and impotence.

“This study should reassure people with prostate cancer that, with a lower risk cancer, they don’t need to receive treatment right away,” said Lisa Newcomb, PhD, a cancer prevention researcher at Fred Hutch, first author of the study and CanaryPASS deputy director. “By utilizing active surveillance, patients visit the clinic for regular exams and occasional biopsies and PSA tests, and many can avoid invasive treatments altogether.”

Researchers from CanaryPASS are working to develop better biomarkers that can identify earlier which patients will develop more aggressive prostate cancers to help more men avoid unnecessary and uncomfortable treatment.


Journal Link: JAMA