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Why treatment for more patients with low-risk prostate cancer patients



Men with endangered prostate cancer in the United States, also use the watch-and-fan approach, also known as "active surveillance" in 2015, up from 14.5% in 2010, of According to studies published in the JAMA medical journal on Monday.
Compared to high risk prostate cancer or intermediate risk, prostate cancer is highly affected by low risk, which is why "active surveillance" can be considered as an alternative to the treatment of options such as surgery or radiation therapy . Surgery and radiotherapy can get some side effects, including a higher risk of construction or accidental urine or stomach leakage problems.

Given that active surveillance carried out between 201

0 and 2015 was used, the most common way to manage a low risk of prostate cancer, according to the study.

"The use of active surveillance was found at risk of low-risk prostate cancer," said Dr. Brandon Mahal, a clinical person in radiation oncology at the Dana-Farber Cancer Cancer Institute in Boston and the first author of the study .

"Overall, it's a good sign and these things," he said. "From 2010 to 2015, there is a lot of new evidence – the highest level of evidence we can obtain in medicine, with prospective trials and some random tests – showing active surveillance, conservative or non-verbal Preventative results at a low-risk prostate cancer treatment approach. "

& # 39; This study is actually the benchmark & ​​# 39;

In the world, prostate cancer is the second most common cancer among men. 1.3 million new prostate cancer cases say in 2018, says the World Cancer Research Fund.
In the United States, 11.2% of men with prostate cancer have been diagnosed at some point during their lives, according to the National Cancer Institute.
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Include the study New data on 164,760 men diagnosed with prostate cancer in the United States between 2010 and 2015. The data, derived from the Surveillance database, Epidemiology, and Results Results, included the treatment approach of each man.
The researchers found that the use of active surveillance increased when radical prostatectomy – or parts of the prostate gland – increased from 47.4% in 2010 to 31.3% in 2015. Radiotherapy was also reduced by drop from 38% in 2010 to 26.6% in 2015, researchers found out.

Men with an intermediate risk disease, between 2010 and 2015, have increased from 5.8% to 9.6% on active surveillance; prostatectomy decreased from 51.8% to 50.6%; and radiotherapy went from 42.4% to 39.8%, found by researchers.

Men with a high risk disease, active surveillance did not change almost unchanged, ranging from 1.9% to 2.2%; prostatectomy increased from 38% to 42.8%; and radiotherapy reduced from 60.1% to 55%, found by researchers.

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The study had a number of limitations to the prostate cancer examination

-This has included analysis of trends only within a five-year period. Further research is needed to determine trends over a longer period and how these trends can impact on public health. The study also did not contain details of whether patients actually responded to doctors in respect of active surveillance or other management approaches.

But overall, "this study is really the benchmark for the surveillance rates in the United States," said Mahal.

"Other studies examined the same question and received increased rates, but those studies were done with databases or databases less that type of information was not collected," he said. "In addition, it is important to continue to follow these trends to make sure that the management rates in the United States, and to know them in the population, how patients make active surveillance."

& # 39; Great change in medical practice & # 39;

A study published in JAMA last year found that the use of a conservative approach to managing cancer – including active surveillance – from 27 % in 2005 to 72% in 2015 among men with low-risk prostate cancer in an integrated Veterans Affairs healthcare system that was younger than 65 and from 35% in 2005 to 79% in 2015 among those aged 65 and over .
"It is very exciting that the number of people in receipt of conservative management for low risk has increased so much over time over a prostate cancer … It still seems that there is still a long way to go , "said Dr. Stacy Loeb, urologist and assistant professor of colonial and human health at NYU Langone Health in New York.
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[19659003] "For anyone in the low-risk prostate cancer category, we now know that prognosis is good even without any treatment," said Loeb, who was not involved in the new research but was the first author The last year's study is

. on radiation or prostatectomy, "these treatment options have potential side effects, such as the impact on erectile function, urination and, in some cases, bowel function," she said. "It is therefore an attractive choice for men to monitor the cancer and then delays treatment on an essential basis if cancer oversight has become more aggressive."

The new study shows how the medical community continues to grow to understand how best to treat certain types of cancer, Dr. J. Leonard Lichtenfeld, interim chief medical officer at the American Cancer Society, who was not involved in the research.

"We've really come in a long way towards getting a better understanding of how to screen prostate cancer and, when we feel prostate cancer, is the best way to treat that prostate cancer and understand that not everyone needs to remove or rotate their prostate, "Lichtenfeld said.

"This does not mean that they do not need radiation or surgery. The whole point of watching these men is to find out if their prostate cancer changes their behavior over time. If it becomes more aggressive , give treatment to those who really need it, "he said. "This is a major change in medical practice."


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