Active Surveillance Conference

December 7, 2011

Whilst the recently concluded conference on Active

Surveillance is a very important one I believe that Dr Myers may have jumped

the gun somewhat in his video a link to which is being posted, and focussed on

an issue that may be somewhat misleading if his remarks are based on the draft

report from the conference.

for yourselves and see if you come to a different conclusion to that

presented by Dr Myers. It seems that the relevant section of the report upon

which Dr Myers' statement is based is on page 14, line 7 <snip> The

30-day mortality of radical prostatectomy is one-half percent. <snip> This

presumably refers to the risks associated with any major surgery.

On the other hand in line 4 on the same page the statment

is made

<snip> There is weak evidence from cohort

studies that observational strategies result in an increase in death rates

relative to both radiation therapy and radical prostatectomy. <snip>

What is undoubtedly likely to be an unintended

consequence of this meetings is that the number of men diagnosed with Gleason

Scores of 3+3=6 will decline and the number diagnosed with GS 7a (3+4) and 7b

(4+3) will increase. We have already seen this, dubbed the Gleason Migration,

after the decision was made to no longer define Gleason Grade 2 material as

'cancer'. This meant that GS 5 diagnoses disappeared, but GS 6 diagnoses

increased.

It seems likely now that pathologists may proceed

with the proposal to use a third focus. This will mean that if there is any

material graded as 5 in a sample, this will lead to a Gleason Score of 8 or 9.

A scary proposition.

All the best

Prostate men need enlightening, not frightening

Terry Herbert

- diagnosed in 1996 and still going strong

Read A Strange Place for unbiased information at http://www.yananow.org/StrangePlace/index.html

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