‘Watch and Wait’ With Small Renal Masses: When and How Should Docs Intervene?
Active surveillance of small renal masses appears to be safe, but if intervention does become necessary, what should trigger it? “We now know that with at least 10 years of data that active surveillance is safe and non-inferior to primary intervention,” said Phillip Pierorazio, MD, of the University of Pennsylvania in Philadelphia, during a presentation […]
Should Older Prostate Cancer Patients Jump Off the Active Surveillance Train?
Come December, as I observe my “pros-mitzvah” — 13 years on active surveillance (AS) for very low-risk prostate cancer — I feel I’m at a tipping point. Should I stay the course and keep monitoring my lesion — a single Gleason 6 of less than 1 mm seen back in 2010 and never again in […]
Take Risk Into Account Before Repeat Surveillance Colonoscopy, Study Says
A majority of older adults undergoing surveillance colonoscopy were invited to return for a subsequent colonoscopy, even when no significant polyps were detected and they had a limited life expectancy, a study using Medicare claims data found. Of nearly 10,000 adults 65 and up undergoing surveillance colonoscopy due to a prior polyp, colonoscopy turned up […]
Use of Active Surveillance in Prostate Cancer on the Rise, but Highly Variable
While use of active surveillance for the management of low-risk prostate cancer has increased in the U.S., it still varies widely both at the practitioner level and even within urology practices, according to a cohort study. Looking at over 20,000 patients included in a quality reporting registry, the rate of active surveillance increased “sharply and […]
Experts Say Tracking Pathogens in Sewage Works, but Needs Sustained Investment
Surveillance of wastewater systems proved useful during the COVID-19 pandemic and merits further investment to respond to future threats, according to a new report from the National Academies of Sciences, Engineering, and Medicine (NASEM). But there’s room for improvement. The report highlights five core pillars for developing a stronger National Wastewater Surveillance System (NWSS), calling […]
Short-Course Apalutamide to Reduce Active Surveillance Attrition in Prostate Cancer
A majority of men in active surveillance (AS) for early prostate cancer had negative biopsies after a 90-day course of apalutamide (Erleada), a small phase II trial showed. Follow-up pathology showed no evidence of residual cancer in 13 of 22 evaluable patients following treatment with the androgen receptor inhibitor. The median time to a positive […]
Survival No Better With Intensive Surveillance in Endometrial Cancer
An intensive surveillance regimen for endometrial cancer did not improve overall survival (OS) over a minimalist regimen, even in high-risk patients, results from the randomized TOTEM trial showed. After a median follow-up of 69 months, the 5-year OS rate was 90.6% with the intensive approach versus 91.9% with the minimalist approach, which mainly included physical […]
Should We Use PSA to Find Active Surveillance Candidates?
As a patient on active surveillance (AS) since 2010, I always considered AS a solution for men like me with very low-risk prostate cancer. Is it time to rethink that? E. David Crawford, MD, a urologist and a long-time prostate cancer researcher, surprised me when he explained that in his view, prostate-specific antigen (PSA) testing […]
Can Prostate Cancer Patients on AS Delay Surgery at Progression?
Among men with clinically localized prostate cancer who continued active surveillance (AS) after biopsy progression, delaying surgery did not significantly reduce recurrence-free survival (RFS) rates or increase the risk of adverse pathology, researchers reported. In a prospectively followed cohort, men on AS who underwent early radical prostatectomy (RP) had a 3-year RFS rate of 80%, […]
Surveillance for Prostate Cancer Is on the Rise — Do Men Stick It Out?
While the uptake of active surveillance (AS) for low-risk prostate cancer has increased over time, about half of patients eventually discontinue this strategy, according to an observational Canadian population-based study. The use of AS increased from 38% in 2008 to 69% in 2014; however, over this study period, 50.8% of patients discontinued AS and proceeded […]