Exciting News for High-Risk Prostate Cancer from a Controlled Randomized Trial
It's Prostate Cancer Awareness Month and although prostate cancer is the most common cancer in men, excluding skin cancers, it ranks relatively low in cancer mortality. In fact, many men with low-risk prostate cancers should be encouraged to avoid treatment entirely and pursue active surveillance, or “watchful waiting”. This is not true, however for the high-risk prostate cancers defined as having PSA blood tests of >20 or poorly differentiated tumors on biopsy, i.e. Gleason 8-10 cancer. These cancers are much more aggressive, and are often not controlled with surgery alone.
For decades, physicians treating prostate cancer have had to rely on retrospective patient outcome data to compare the various treatment options, which are known to be statistically unreliable. Fortunately, this past year an excellent controlled randomized trial was reported from British Columbia that now provides us with reliable long-term data.