John T said...
The NIH has just released a statement from its conference on AS.
The whole text can be read at:
http://prostatecancerinfolink.net/2011/12/07/nih-panel-statement-on-active-surveillance-in-prostate-cancer/
Highlights are:
1. since 1987, the advent of psa screening, there has been a spike in PC detection, but a lack of increase in the PC death rate.
2. At 20 years follow up only 5% of men with low risk cancer die.
3. More than 63% of all PC is G6.
4. Only 10% of those eligable ever choose AS.
5. Early results from many studies indicate disease free survival rates that compare favorable to curative therapy.
6. No futher studies are needed to prove the effectiveness of AS on low risk patients with a life expectancy of <20 years.
7. More randomized clinical trials are necessary to determine effectiveness of AS for life expectancy > 20 years.
8. Strong consideration should be made to remove the anxiety provoking term "cancer" to low risk cancer. (This should make Casey very happy)
JohnT
To add something substantive to the discussion, I would most likely qualify for point #7. I guess I would be one of the 10% from #4.
And, assuming the data collected was from 1987 forward, I wonder how many of the 5% in #2 went untreated? At most it would be 10%, or .5% that died from low risk, untreated disease. To me, that suggest 99.5% of low risk men lived 20 years or more, and at most only 10% of those (9.95%) were untreated. That means, 89.05% of low risk men went on to treatment and lived at least 20 more years. Those are good odds for treatment for low risk disease if you ask me. And that doesn't even address the issue of "low risk" definition changes through the years.
I am dizzy from all the math. Please someone point out my errors.
Be well..