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NCCN emphasizes active surveillance in new prostate cancer guidelines
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The National Comprehensive Cancer Network has updated is Clinical Practice Guidelines for Oncology for Prostate Cancer with new recommendations that emphasize the use of active surveillance — or watchful waiting — in certain patient populations.
“Growing evidence suggests that over treatment of prostate cancer commits too many men to side effects that outweigh a very small risk of prostate cancer death,” said James L. Mohler, MD, of Roswell Park Cancer Institute and chair of the NCCN Guidelines Panel for Prostate Cancer.
In the first of two updated guidelines, the NCCN recommends the use of active surveillance, and no other treatment, in men with a low risk for prostate cancer who have a life expectancy of less than 10 years.
The second guideline update is for men in a new “very low risk” category. This category has been added using a modification of the Epstein criteria for clinically insignificant prostate cancer. In this group of men, active surveillance is offered and recommended for men who have a life expectancy of less than 20 years.
To make these recommendations, the NCCN panel took careful consideration, including a thorough review of evolving data, of which men should be recommended for active surveillance. In addition, the new guidelines stress that active surveillance involves actively monitoring the course of the disease with the expectation to intervene if the cancer progresses.
