No disadvantage due to delayed start of therapy

Men diagnosed with localized prostate cancer should not be put under unnecessary time pressure when choosing treatment. At this year's meeting of the American Society for Clinical Oncology (ASCO), the scientists spoke out in favour of this. As an American study recently showed, a delayed start to therapy does not have any negative effect on the healing of prostate cancer with a medium and higher risk. 

In almost 80 percent of the cases, prostate cancer is at a stage at the time of diagnosis where the tumor is limited to the organ and the chance of cure is very good. In addition, prostate carcinoma is usually a relatively slow-growing tumor type. Nevertheless, many men feel that they do not lose any time and act quickly,"says Dr. Pedram Derakhshani, urologist at the West German Prostate Center in Cologne. 

More than 3,000 patients with a localized tumor of medium and higher risk were analyzed in order to investigate whether delayed initiation of therapy after prostate cancer diagnosis has a negative impact on the risk of recurrence. 1 More than 3,000 patients with a localized tumor of medium and higher risk were diagnosed with the disease. Patients were divided into three groups and observed over a period of 25 months. In the first group patients received treatment within 90 days, in group 2 within 90 - 180 days and in group 3 after 180 days.

The results clearly show that there were no differences in the success of the therapy regardless of the time of treatment. For example, the risk of recurrent disease was statistically the same in all three groups (4.9 to 9.6 percent). It is true that patients whose tumor has already progressed further should not receive active surveillance but rather "active treatment". However, the results indicate that a short-term delay to carry out additional imaging procedures or to obtain a second opinion is safe.

Dr. Derakhshani also recommends that the diagnosis of prostate cancer should not cause unnecessary time pressure, even in the case of more aggressive tumours. "The therapy decision should always be made with good information and a good feeling, regardless of the tumor stage." It is also advisable to seek the advice of doctors from various specialist groups - urologists and radiotherapists, the Cologne urologist emphasises.


Sharval S. et al.: The impact of treatment delay from diagnosis to prostatectomy on the biochemical recurrencerate, J clin oncol 35,2017

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