The latest issue of the PCRI Insights has two articles on AS; one by Dr Stan Brosman who details studies by L Klotz, and the other by a patient currently on AS being monitored by Dr Duke Bahn.
Only 35% of patients qualifying for AS actually go on AS.
20% of those drop out without any sign of progression because their anxiety is too high.
25% are adivised to start treatment because of progression and all of these showed progression within the 1st 5 years.
The remaining are still on AS.
The long term results of those who sought treatment are the same as those who elected immediate treatment.
Study began in 1999 and median follow up is 6.8 years (50% of patients greater than 6,8 years)
Dr Bahn's criteria for AS:
G6
PSA less thn 10; PSA density <.15
Biopsy cores less than 30%
% cores < 50%
PSA doubling time > 2years; 3 years perferred
Tumor neovascularity on Color doppler 1+ or less
Tumor volume on CDU: less tha 1cc
PCA3 test less than 35
Ploidy: Diploid
Patient's comments: 55 years old, on AS for 5 years, Dad died of PC at 76.
All doctors (4) recommended immediate treatment because of age.
Very little encouragement from support groups and friends.
Was monitored yearly at UCSF by MRIS
Changed monitoring to Color Doppler and Dr Bahn and now feels much more comfortable with decision and monitoring.
PSA anxiety is similar to those in his support group that received treatment. Everyone stills worries about psa rise.
JT