Watchful Waiting/Active Surveillance for Prostate Cancer MA Prostate Ca Symposium May 15, 2006. Martin G. Sanda, M.D. Director, Prostate Care Center at BIDMC Associate Professor, Harvard Medical School. Active Surveillance for Early Stage Prostate Cancer.
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for Prostate Cancer
MA Prostate Ca Symposium
May 15, 2006
Martin G. Sanda, M.D.
Director, Prostate Care Center at BIDMC
Associate Professor, Harvard Medical School
Clinical Staging - Rectal exam
Detecting Aggressive vs Indolent Prostate Cancer: a) Anti-AMACR autoantibody associated with Gleason Score (p=0.01) &b) more accurate in identifying aggressive Ca than PSA by ROC (AUC 0.65 vs 0.55)
56 yrs, PSA = 14.8;
DRE: Right nodularity
MRI: capsular extension
Biopsy: initial – low risk (1/6; 10% Gleason 6) f/u - right 3/6 biopsy cores have cancer (50% of bx core) Gleason = 6
A Randomized Phase II Trial of Dutasteride versus Placebo in Patients with Early Stage, Low Risk Prostate Cancer Who Choose to Defer Surgery or Radiation
Martin G. Sanda, M.D. PI
Glenn Bubley, M.D. co-PI
Jonathan Epstein, M.D. co-PI
ECOG GU Early Modalities Subcomittee (GEMS)
Conservative management via periodic biopsy with standardized criteria of tumor progression will be a feasible alternative to immediate local therapy in patients with low risk prostate cancer, and a 5 alpha reductase inhibitor will alter tumor progression
Histopathological progression endpoint
Study Design: Phase III Randomized Trial
Duration of Follow-up
For this protocol, all patients, including those who discontinue protocol therapy early, will be followed for response until progression and for survival for 10 years from the date of registration.