As Prescribed: Watching, waiting and treating prostate cancer


SAN FRANCISCO (KCBS RADIO) – This year, around 300,000 people are expected to receive a prostate cancer diagnosis. Still, most of those people aren’t expected to develop fatal, or even aggressive disease.

How can they be sure they’re prepared if their cancer does become aggressive? Dr. Matthew Cooperberg of UCSF explained how the “active surveillance” approach is key to treating prostate cancer patients this week on “As Prescribed” with KCBS Radio’s Alice Wertz.

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“Most men in whom we find prostate cancer, the cancer never becomes a problem,” said Cooperberg, a urologic cancer surgeon and co-director of the prostate program at UCSF Helen Diller Family Comprehensive Cancer Center.
“It never causes symptoms. It never threatens their life. It’s a low risk cancer – and in fact, the most common cause of death for men with prostate cancer overall is cardiac disease, because that’s what kills most men in the United States.”

At the same time, prostate cancer is the leading cause of mortality of death from cancer among men in the U.S., with more than 30,000 deaths expected this year. That’s why surveillance is important.

“We’re increasingly focused on this idea of risk stratification, personalizing prostate cancer management so that we’re treating the cancers that have to be treated and not treating those that don’t,” Cooperberg explained.

To do this, doctors deploy a range of tests, from prostate-specific antigen (PSA) testing to new blood and urine tests, MRIs, biopsies, imaging, and biomarker tests to look at gene expression.

“Every decision from how we do PSA testing on through how we diagnose prostate cancer and certainly how we treat it really should be individualized and personalized,” said Cooperberg. He said that around 60% of patients with low risk prostate diseased are being managed with this method, but that it should be closer to 90%.

To make sure that they are on the right path when it comes to prostate cancer treatment, people can get tested at age 45 to 50, said Cooperberg. He said that getting a baseline PSA level early in life is important for future treatment.

“A patient on active surveillance should feel just as secure as a patient having surgery or some more intrusive type of approach,” said UCSF patient John Shoemaker of his treatment. Although he was diagnosed more than 16 years ago, Shoemaker said he’s been able to live the same life as he did before the diagnosis. You can read more about his story here.

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