In the past, doctors would automatically recommend treating all prostate cancer patients even if their cancer showed limited or no signs of disease progression. However, doctors nowadays are more likely to favour active surveillance for low to intermediate-risk prostate cancer cases that may never turn deadly, potentially sparing many people unnecessary treatment.
This new approach, known as “active surveillance”, involves routine PSA checks, follow-up biopsies & MRIs for low-grade tumours, with treatment only begun if the tumour has shown signs of progression or malignancy.
Active surveillance has a low risk of adverse health consequences; research published in European Urology by Johns Hopkins University’s School of Medicine showed that the long-term risk of metastasis (when cancer spreads outside the prostate) & death from low-grade prostate cancer in men under active surveillance was only 0.1 per cent.
But how do we know which of these 0.1 per cent of prostate cancer cases need closer monitoring?
New research from the same institution supported a new way of predicting if a low-grade tumour may become more aggressive & need treatment. The predicting tool is known as testing for the perineural invasion (PNI) mechanism – a process of prostate cancer growth that allows cancer cells to escape the prostate to the surrounding tissue. The research found that if PNI was detected, cancer was more likely to progress.
This means that testing for PNI might be a good tool to identify low-grade prostate cancer cases that might become more aggressive. However, PNI was not an absolute predictor of cancer progression, meaning that if PNI is detected, the cancer might not progress. Still, looking at PNI provides more information to doctors on which cases might need closer monitoring.
If you suspect you, or a loved one have prostate cancer, or you require further information, seek professional medical advice immediately.
For more information on the research, head to Harvard Health or for more general information about prostate cancer, look at www.cancer.org.au/cancer-information/types-of-cancer/prostate-cancer
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