Men okay with prostate cancer surveillance: study

Fri Sep 28, 3:34 PM ET
In men with early or "localized" prostate cancer, the strategy of active surveillance of their cancer does not appear to increase levels of psychological stress any more than undergoing immediate treatment does, according to UK researchers.
With active surveillance, or "watchful waiting," patients with early prostate tumors are monitored regularly and only treated if their cancer progresses.
"Our study found that men on active surveillance were no more likely to have anxiety and depression than those who were receiving, or had received, immediate treatment," study chief Dr. Katriina L. Whitaker told Reuters Health. This supports the acceptability of active surveillance as an approach for managing localized prostate cancer.
The paper was published in the September issue of BJU International. Dr. Whitaker's last name at the time was Burnet.
Although studies suggest that many men with localized prostate cancer may not require radical treatment, like surgery, a consequence of active surveillance may be increased psychological stress, Whitaker of University College London and colleagues note.
To determine if this is the case, they followed 329 men with localized disease. One hundred were on active surveillance, 81 were currently receiving radical treatment and 148 had previously received radical radiation therapy.
Overall, 16 percent met criteria for anxiety and 6 percent met criteria for depression. Analysis showed that higher anxiety scores were significantly associated with being younger and with a longer interval since diagnosis. Depression was also significantly associated with a longer interval since diagnosis.
However, anxiety and depression were not significantly associated with management by active surveillance.
The researchers point out that other measures of coping and quality of life might also be important. However, they conclude that close monitoring "was not associated with greater psychological distress than more immediate treatment for prostate cancer."
SOURCE: BJU International, September 2007.