04
Apr
ASPI is a group of prostate cancer patientssurvivors and advocates that will empower men diagnosed with low-risk and intermediate prostate cancer including Gleason 6-7 by providing the latest information to allow for informed decisions with your physician regarding approaches to active surveillance. Any thoughts about this recommendation.
So my question is has anyone else here gone on active surveillance with Gleason 7.
Active surveillance prostate cancer gleason 7. Unfavorable disease was defined as prostate cancer with a Gleason score of 4 3 7 or pathological stage T3 and biochemical failure ie a post-surgical PSA level 02 ngml. Here is a summary of the study findings. 359 men were initially enrolled on active surveillance and followed for an average mean of 729 months.
These data support the use of active surveillance in low risk and intermediate risk cases of Gleason 6 but not Gleason 7 prostate cancer. Multiparametric magnetic resonance imaging and novel biomarkers might be vital in detecting favorable Gleason 7 disease. About 200 men in the study have intermediate-risk prostate cancer.
Usually intermediate-risk cancer is determined by a Gleason score of 7 or a PSA level higher than 10 ngmL. However these intermediate cancers can also be divided into lower- and higher-risk categories depending mostly on how much higher-grade cancer shows up in the biopsy. Laurence Klotz presented on why we should not offer active surveillance AS for Gleason 7 34 prostate cancer.
Klotz began with a brief outline of the known data in 2018. Gleason 3 cells resemble normal cells in most cases with a metastatic potential of zero. Active surveillance may place men with low volume intermediate-risk prostate cancer including a Gleason score of 3 4 7 or Gleason Group 2 at risk for adverse outcomes that could potentially have been avoided with immediate intervention.
According to the American Society of Clinical Oncology patients with low-risk low-grade disease a Gleason score of 6 can consider active surveillance. It may also be an option for patients with a Gleason score of 7. Patients within these categories may choose to postpone prostate cancer treatment because of its associated risks and side effects.
My PSA is 1367 Gleason 3 4 in two cores at -15 one core 33 at-5. He said that Active Surveillance should be safe with regular PSA test but you never know. Although I am an intermediate risk with Gleason score 7 because the percentage is -15 he said this is very similar to a Gleason 6.
Hoewel tot op heden met name mannen met Gleason score 6 voor active surveillance in aanmerking kwamen. El Hallani S et al. Cribriform morphology predicts upstaging after radical prostatectomy in patients with Gleason-score 3 4 7 prostate cancer at transrectal ultrasound TRUS-guided needle biopsy.
Based on the this report the recommendation is to delay therapy and join the MD Anderson active surveillance group. Am told that 15 of the 800 participants have Gleason 7 the remainder have Gleason 6 or less. So my question is has anyone else here gone on active surveillance with Gleason 7.
Any thoughts about this recommendation. With Gleason 7 3 4 tumors most limit this approach to men with Gleason 6 tumors 91820. Most centers do not havestrictcriteriawithregardtopatient ageandoldermen may opt for surveillance despite some higher-risk features choosing to monitor their disease for early signs of progression when secondary local therapy can still be offered.
It is characterized by a routine protocol of close monitoring with digital rectal examination periodic biopsy and serial PSA testing. As defined by DAmico active surveillance is broadly appropriate for men with a Gleason score of 6 or less and a PSA level of less than 10 ngmL. Additionally there has been a significant emergence of evidence for the role of MRI and tissue genomics in active surveillance1415 Perhaps with these tools we will be able to better discriminate between men with Gleason 7 prostate cancer who can and cannot safely monitor their prostate cancer.
The active surveillance usage for patients within the intermediate risk group Supplementary Table 6 was between the usage for patients with a Gleason score 6 or below and the usage for patients with a Gleason score 7 or above. At last active surveillance was introduced in 2010 as a viable management alternative to active treatment. ASPI is a group of prostate cancer patientssurvivors and advocates that will empower men diagnosed with low-risk and intermediate prostate cancer including Gleason 6-7 by providing the latest information to allow for informed decisions with your physician regarding approaches to active surveillance.
In conclusion men with Gleason score 347 prostate cancer represent a heterogeneous group. There are inadequate data regarding the long-term outcomes of active surveillance in these men especially in high-risk populations such as African American men.