Active Surveillance—when to treat

From the 2008 PCRI Conference:

The Univ. Calif. San Francisco criteria for active surveillance are:

PSA less than 10
Gleason Sum 6 or less
No grade 4 or 5 tumor on biopsies
Less than 33% cores positive, and no core with over 50% involvement with cancer
Stage T1 or T2

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Treatment is recommended for “Progression” defined as:

Rise in PSA of more than 0.75 ng/dl per year
Lowering of PSA doubling time
Rise in Gleason score on followup biopsies
Increase in tumor size on ultrasound

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