Active surveillance and prostate biopsies
Active surveillance for prostate cancer – how often do we see no cancer on a second biopsy?
Role of Surveillance Biopsy with No Cancer as a Prognostic Marker for Reclassification: Results from the Canary Prostate Active Surveillance Study. European Urology Volume 73, Issue 5, Pages 706–712
In this study, men on AS for prostate cancer were re-biopsied (surveillance biopsies) as per protocol. On first surveillance biopsy, 32% of men had no cancer, 43% had cancer that was the same ISUP group (Gleason score) as the first biopsy, and 25% had a change in the score on their biopsy.
For those men who had no change or no cancer on the first surveillance biopsy, when they came to their second surveillance biopsy, 38% had no cancer, 44% had the same cancer as originally, and 17% were reclassified. A finding of no cancer on the second surveillance biopsy meant men were less likely to have an upgrading in their cancer in the future. This means that it may be possible to slightly relax the frequency of surveillance in men who have a surveillance biopsy without cancer. It also means that for active surveillance protocols, one size does not fit all, and the frequency of follow up for prostate cancer needs to be tailored for the individual.
If you would like to discuss active surveillance for prostate cancer, please ask you GP to contact Nick Brook and this can be arranged.