Asian Journal of Andrology

AUTHORS REPLY
Year
: 2014  |  Volume : 16  |  Issue : 3  |  Page : 414-

Re: Long-term survival of participants in the Prostate Cancer Prevention Trial


Ian M Thompson1, Catherine M Tangen2, Phyllis J Goodman2,  
1 Cancer Therapy and Research Center, University of Texas Health Science Center at San Antonio, San Antonio, USA
2 Southwest Oncology Group Statistical Center and Fred Hutchinson Cancer Research Center, Seattle, USA

Correspondence Address:
Ian M Thompson
Cancer Therapy and Research Center, University of Texas Health Science Center at San Antonio, San Antonio
USA




How to cite this article:
Thompson IM, Tangen CM, Goodman PJ. Re: Long-term survival of participants in the Prostate Cancer Prevention Trial.Asian J Androl 2014;16:414-414


How to cite this URL:
Thompson IM, Tangen CM, Goodman PJ. Re: Long-term survival of participants in the Prostate Cancer Prevention Trial. Asian J Androl [serial online] 2014 [cited 2021 Sep 28 ];16:414-414
Available from: https://www.ajandrology.com/text.asp?2014/16/3/414/125714


Full Text

We appreciate the opportunity to comment on Dr. Silberstein and Sartor's commentary on our recent update of the Prostate Cancer Prevention Trial.[1]

We are disappointed that the authors did not reflect on perhaps the greatest challenge to prostate cancer in the USA today: the severe risk of overdetection and overtreatment. Indeed, this risk is so compelling that it led the US Preventive Services Task Force to recommend against prostate-specific anitgen testing. Data are clear that in our effort to detect cancers that we know we can help, we find orders of magnitude more cancers that we simply do not help. Even for the small fraction of men who are not treated but are managed with active surveillance, the data are clear: it costs as much as surgery and the repeated clinic visits and biopsies adversely affect their quality of life and place them at medical risk.

One perspective of 5-alpha reductase inhibitor-based prevention is in the context of an overall early detection strategy. This class of agents reduces detection (and treatment) of inconsequential tumors, while preserving and enhancing detection of aggressive tumors that benefit from detection. We suggest that this information be provided to men who have opted for prostate-specific antigen screening; it can then be the privilege of the individual patient to perform the risk-benefit assessment for himself rather than the physician's priorities dictating whether cancer prevention is appropriate.

We continue to seek improved methods to identify the individual who is most likely to benefit from the use of these agents.

References

1Silberstein JL, Sartor O. Long-term survival of participants in the prostate cancer: prevention trial. Asian J Androl. 2014. doi: 10.4103/1008-682X.122868. [Epub ahead of print].