Low-risk prostate cancer patients who simply had their condition observed instead of immediately treated saved money and had better results.
"Watchful waiting" as opposed to "active surveillance" added two months of quality-adjusted life expectancy and saved an $11,000 to $15,000, according to Medpage Today.
Watchful waiting is a strategy of simply observing the patient, while active surveillance involves "close follow-up after diagnosis, typically with serial PSA testing, digital rectal exam, and prostate biopsies." The final option is treating the cancer immediately.
"Using our results, we estimated that if the number of newly diagnosed men with low-risk prostate cancer who selected observation with watchful waiting increased from 10 percent to 50 percent, it would result in a cost savings of more than $1 billion," said Julia Hayes, MD, of Harvard and Dana-Farber Cancer Institute in Boston, who participated in the study.
The study found six percent of men who opted for watchful waiting died from the cancer, 4.8 percent undergoing active surveillance passed away, and eight percent of men had fatalities from the disease.
Men with low-risk prostate cancer only have a six percent chance of dying over the next 15 years, but 90 percent of those diagnosed go through radical prostatectomy or radiation therapy immediately.
Recent studies suggest 60 percent of patients who undergo these treatments are doing it unnecessarily, and will even experience adverse side effects over the course of their life as a result.
"As we better classify men as low risk by adding molecular and imaging techniques currently in development to standard clinical parameters, prospective studies should determine whether less surveillance than is typically done on active surveillance is safe for men who select observation for low-risk prostate cancer," Hayes said. "These findings provide further support for watchful waiting and active surveillance as reasonable and underused options for men with low-risk prostate cancer."
"We have to start selecting patients for treatment or some sort of observation," Art Rastinehad, DO, of North Shore-LIJ Health System, said. "It also raised the question of how do we select patients for treatment versus not."
