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    PCa studies: Optimized screening, treatment selection essential

    Questions about the optimal approach to prostate cancer screening and treatment for the disease continue to have urologists and other practitioners searching for answers. Four studies presented at the 2015 AUA annual meeting in New Orleans shed some light, with researchers emphasizing the need to optimize screening and to improve treatment selection in older men.

    Read - PSA access tops AUA legislative priority list

    Stacy Loeb, MD, MSc, of New York University School of Medicine, New York, who moderated a press briefing about the research, spoke with Urology Times in a one-on-one interview. She shared her insight on the study findings and what they mean for clinicians.

    Click here for video

    Comparing different treatment options

    Stacy Loeb, MD, MScThe first study, presented by Matthew Cooperberg, MD, MPH, of the University of California, San Francisco, examined data from CaPSURE, a community-based prostate cancer registry of 47 clinical sites across the U.S. (since 1995). Researchers compared prostate cancer-specific deaths across all major primary treatment alternatives, including local treatment, surgery, brachytherapy, external beam radiation, and primary hormonal therapy.

    “We don’t know exactly what is the best kind of treatment,” Dr. Loeb said. “In his data set, he [Dr. Cooperberg] showed that for all comers, prostatectomy had the lowest rate of prostate cancer death. But if you just look in the low-risk group of patients, there was no difference between any of the treatments or active surveillance/watchful waiting.”

    Also read - Study: Men receiving non-recommended PSA Screening 

    The study found active surveillance was a viable option for most men with low-risk prostate cancer, and aggressive multimodal treatment, including surgery, was effective for men with high-risk disease.

    “It appears that surgery is a great option as a first treatment for high-risk disease and, at least in this non-randomized data, reduces the risk of prostate cancer death. For low-risk disease, active surveillance is safe and should be encouraged,” said Dr. Loeb.

    Next: Prostate cancer patterns in elderly men

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