Active Surveillance For Black Men With Prostate Cancer – Black men diagnosed with early-stage prostate cancer can practice active surveillance just like their white counterparts instead of heading straight into surgery or radiation, a new study has determined.
The finding, recently published in the Journal of Urology, comes from a large research collaboration known as the Canary Prostate Active Surveillance Study, or Canary PASS, led by Fred Hutchinson Cancer Research Center.
“I think this is good news for African American men,” said Dr. Daniel Lin, principal investigator of the Canary PASS cohort, the large patient registry that has fueled the decade-long prostate cancer initiative. Canary PASS funding was just extended for another five years.
“There have been some conflicting reports as to whether it’s safe to use active surveillance in African American men,” Lin said. “One report said they might have slightly higher rates of finding worse cancers during active surveillance, but that was a smaller study.
“We had more African American men in our cohort and found there was no difference between the men who did active surveillance; no difference between blacks and whites.”
What is active surveillance?
Around a third of early-stage prostate cancers are slow-growing and thus are low risk. Radical treatments aren’t necessarily beneficial in these cases; instead, these men can be monitored through “active surveillance,” the standard of care recommended by national cancer organizations such as the American Society of Clinical Oncology.
In this approach, men diagnosed with early-stage disease receive regular PSA (prostate-specific antigen) testing, biopsies and digital-rectal exams to keep tabs on their cancer. Active surveillance is different from another less-vigilant approach often used in older men called “watchful waiting.”
“Active surveillance is for those who are able to recognize their tumor is not aggressive and might not even need to be treated,” said Lin, who also serves as the director of the Hutch and UW Medicine’s Institute for Prostate Cancer Research. “We follow them and do surveillance with PSAs and serial biopsies and other tests since prostate cancer can go from low risk to higher risk.”
Lin said that out of 100 patients who start active surveillance, 50 percent will go on to have treatment within the first 10 years.
“But half are still free of being treated,” he said. “The men in this study are hoping to avoid treatment because of side effects such as incontinence or leakage or erectile dysfunction.”