Avoiding Overtreatment After Prostate Cancer Biochemical Recurrence: Long-term Outcomes Without Adjuvant Therapy
Friday, May 15, 2026 2:50 PM to 3:10 PM · 20 min. (America/New_York)
Salon B
Detail
APP/Allied Health
Information
Presentation Goal: This presentation aims to provide APPs with evidence-based insight into managing prostate cancer biochemical recurrence (BCR) conservatively through active observation, identifying patients that are suitable for delaying or avoiding androgen deprivation therapy (ADT) or radiation therapy (RT) without elevating the risk of progression.
Presentation Description: Prostate cancer BCR often progresses slowly, and most cases do not result in prostate cancer-specific mortality (PCSM), suggesting that immediate ADT or RT may not be necessary for all patients. Between 2002-2014, 287 men developed BCR following robot-assisted radical prostatectomy, of which 105 (36.6%) were managed under Active Observation (AO). Over a 9-21 year follow-up, 82% successfully avoided ADT/RT, with only one PCSM. This presentation will highlight long-term outcomes demonstrating that PSA doubling time kinetics, rather than pathology alone, can safely guide observation. APPs play a vital role in patient monitoring, PSA tracking, and counseling regarding treatment timing. This approach may significantly reduce overtreatment and associated morbidities, empowering APPs to support personalized, evidence-based follow-up strategies.
I will discuss:
• The natural history of prostate cancer biochemical recurrence and its typically slow progression.
• Criteria and PSA kinetics (doubling time and trends) used to identify appropriate candidates for Active Observation (AO).
• Long-term outcomes (9-21 years) demonstrating safety and low prostate cancer-specific mortality with delayed intervention.
• Clinical parameters that predict success with AO versus progression requiring ADT/RT.
• APP’s role in longitudinal monitoring, PSA tracking, and patient counseling to prevent overtreatment.
• How AO can reduce treatment-related morbidity and improve quality of life.
Presentation Description: Prostate cancer BCR often progresses slowly, and most cases do not result in prostate cancer-specific mortality (PCSM), suggesting that immediate ADT or RT may not be necessary for all patients. Between 2002-2014, 287 men developed BCR following robot-assisted radical prostatectomy, of which 105 (36.6%) were managed under Active Observation (AO). Over a 9-21 year follow-up, 82% successfully avoided ADT/RT, with only one PCSM. This presentation will highlight long-term outcomes demonstrating that PSA doubling time kinetics, rather than pathology alone, can safely guide observation. APPs play a vital role in patient monitoring, PSA tracking, and counseling regarding treatment timing. This approach may significantly reduce overtreatment and associated morbidities, empowering APPs to support personalized, evidence-based follow-up strategies.
I will discuss:
• The natural history of prostate cancer biochemical recurrence and its typically slow progression.
• Criteria and PSA kinetics (doubling time and trends) used to identify appropriate candidates for Active Observation (AO).
• Long-term outcomes (9-21 years) demonstrating safety and low prostate cancer-specific mortality with delayed intervention.
• Clinical parameters that predict success with AO versus progression requiring ADT/RT.
• APP’s role in longitudinal monitoring, PSA tracking, and patient counseling to prevent overtreatment.
• How AO can reduce treatment-related morbidity and improve quality of life.
Of Interest To
Advanced Practice Providers (APP)
