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A national, proactive prostate cancer surveillance initiative

Posted May 27 2010 12:00am

The Prostate Cancer Foundation (PCF) has announced plans for a National Proactive Surveillance Network (NPSN) designed to reduce overtreatment of prostate cancer patients to better direct resources to those patients with more aggressive, life-threatening varieties of this disease.

According to a media release this morning, the NPSN will provide “a nationwide program for medical professionals to provide better tracking and prediction of disease progression in patients whose prostate cancer has a higher probability of being slow-growing and non-life threatening.”

This initiative is a cooperative effort of PSF in conjunction with Johns Hopkins Medical Center in Baltimore and Cedars-Sinai Medical Center in Los Angeles. The program will employ the proactive surveillance protocol originally developed by physicians at Johns Hopkins University Medical Center and a secure online site that patients and their physicians can privately access to enter, review and track their data on a regular basis.

The online interface will be available for use later this year and will be available to any physician/patient team that wishes to access the network. It will be built to be fully HIPAA compliant to ensure patient privacy. Stuart Holden, MD, director for the Louis Warschaw Prostate Cancer Center at Cedars-Sinai Medical Center, and Ballantine Carter, MD, director of adult urology services at Johns Hopkins, will serve as co-principal investigators for the program.

“We are excited to announce the formation of the National Proactive Surveillance Network,” explained Jonathan W. Simons, MD, president and CEO of PCF. “Until we have a better biomarker at our disposal for distinguishing between slow-growing and aggressive, life-threatening varieties of prostate cancer, this program will help us prevent overtreatment of patients, giving them more confidence in the screening tools we have today and their treatment decisions.”

The Johns Hopkins active surveillance protocol is based on the premise that older patients with a low PSA level relative to prostate volume and who have evidence of small-volume, low-grade cancer (Gleason score 7) or more extensive disease, patients are then advised to undergo treatment with curative intent (with either radiation or surgery). About 800 patients with an average age of 67 years have been enrolled in the program since it was initiated at John Hopkins. According to Dr. Carter, “Fifty-six percent have remained active, 32 percent have undergone curative intervention and two percent have died of causes other than prostate cancer. Ten percent have either been lost to follow-up or have withdrawn from the program.”

PCF further states that “In addition to providing an efficient model for proactive surveillance, the NPSN will collect and sort data blindly with absolutely no patient name association so researchers can analyze trends and the success of the program.” Patient samples, including blood and urine, will be analyzed and banked by Johns Hopkins University Medical Center and by Cedars-Sinai Medical Center on the east and the west coasts, respectively. This blood and urine specimen repository will support future research on potential new biomarkers and on the genetics of prostate cancer.

The “New” Prostate Cancer InfoLink sees this as an interesting and potentially important new research initiative that may help us to better understand which prostate cancer patients can be managed conservatively, with minimal risk to their long-term health and care. We hope that other major centers will be able to find ways to collaborate in this initiative over time.

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