AUA Responds to Johansson et al Article on Prostate Cancer Survival Rates

The American Urological Association (AUA) feels that the article byJohansson et al in the February 12th issue of the Journal of the AmericanMedical Association, indicating comparable survival rates for localizedprostate cancer patients who choose aggressive therapy and patients whoopt for a "watchful-waiting" approach, presents a limited snapshotof the prostate cancer picture.

According to the AUA, a clearer, more comprehensive picture of prostatecancer survival is available in the treatment guidelines for localizedprostate cancer released by the AUA in late 1995 and in a study by Gerberet al published in the August 28, 1996, issue of JAMA.

Aggressive Approach Advocated in Younger Men

The AUA treatment guidelines for localized prostate cancer were developedafter an exhaustive review of the peer-reviewed literature. According tothis comprehensive review, the available research data indicate that youngermen and those with at least a decade or more of life expectancy shouldbe aggressively evaluated and treated in order to decrease unnecessarydeath and suffering from prostate cancer.

Similar to Johansson and colleagues, the AUA prostate cancer guidelinesrecommend that treatment decisions should be based on the age and lifeexpectancy of the patient, the characteristics of the patient's tumor,and patient preference. The guidelines strongly emphasize patient involvementin treatment decision-making, and they encourage urologists to fully informprostate cancer patients about the potential benefits and risks of commonlyaccepted therapies, including surgery, radiation treatment, and watchfulwaiting.

The August 28, 1996, JAMA article by Glenn Gerber, md, and colleaguesat the University of Chicago School of Medicine clearly associated radicalprostatectomy with long-term survival in men diagnosed with early prostatecancer.