BACKGROUND: Curative treatment for prostate cancer is associated with risks which may adversely influence quality of life.
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Furthermore, there is a considerable rate of overdiagnosis of tumors which would be non-life-threatening if left untreated. Efforts have been made to reduce overtreatment.
DISCUSSION: Beside the traditional conservative symptomatic management especially in elderly patients with meaningful comorbidity, several prostate-sparing or deferred treatment options are currently discussed. For all of them, insufficient data on efficacy and safety are available.
RESULTS: Because of the required long-term follow-up of large sample sizes, conclusive data will not become available in the near future. Therefore, these treatment options have to be considered experimental to a large degree. This applies both to focally ablative techniques and to active surveillance of prostate cancer in patients with a long further life expectancy. Only in carefully selected patients with favorable tumor-associated risk profiles and high risk of medium-term competing mortality may active surveillance be considered a valid and relatively safe treatment option.
Fröhner M, Wirth M. Are you the author?
Klinik und Poliklinik für Urologie, Universitätsklinikum "Carl Gustav Carus" der Technischen Universität Dresden, Fetscherstraße 74, 01307, Dresden, Deutschland.
Reference: Urologe A. 2014 Sep;53(9):1295-301.
Article in German.