Thyer Urology

PRIAS Study

The PRIAS study is the largest continuous study of men undergoing AS for prostate cancer. The following questions about AS were answered in the study:

How many men continue on AS?

• At 5 years about 50% of men were still on AS
• At 10 years about 25% of men were still on AS

Why did they discontinue AS?

Of the men that discontinue AS about 2/3 are due to cancer progression and 1/3 due to patient desire for treatment

Of the men who stopped AS and then underwent radical prostatectomy how bad was their disease?

Pathology showed 2/3 had intermediate or high risk prostate cancer and 1/3 had low-risk prostate cancer

How many men on AS developed incurable disease because they chose AS?

Of the 5000 men enrolled in the study about 50 developed incurable disease by the end of the 10 year period. This is a rate of about 1%. Of these:

• 30 had positive PSA after undergoing treatment
• 10 had local recurrence in the pelvis
• 8 had metastatic prostate cancer
• 1 man died

Protocol

Mr Thyer will follow the following protocol for all men on AS:

• PSA 6 monthly
• Prostate examination yearly
• Repeat MRI and biopsy at 1, 3, 7, 12 years

Advantages of AS

• Avoiding the side effects of treatment with surgery or radiotherapy

Disadvantages of AS

• Anxiety of not treating the cancer
• Multiple rectal examinations and biopsies
• Chance of cancer progression or becoming incurable

For more information:

• PCFA – Active Surveillance
• Cancer Council of Australia - General information
• PCFA - General information
• Cancer Australia - Statistics