We are reaching a point where active surveillance may be more acceptable for men  with early unaggressive prostate cancer. At a recent PHEN conference in Washington, DC a presenter from the NCI said that a significant number of men were choosing active surveillance for prostate cancer. He said that a significant men would eventually drop out of the protocol and that often this was related to anxiety they were experiencing because of their fear that the cancer was growing beyond control.

A recent Reuters article discusses this issue:

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.

To read the entire article click here.