What are the AUA/ASTRO/SUO treatment guidelines for high-risk prostate cancer?

Updated: Jul 31, 2017
  • Author: Bagi RP Jana, MD; more...
  • Print
Answer

Answer

For high-risk patients the guideline recommendations include the following:

  • Clinicians should stage high-risk localized prostate cancer patients with cross-sectional imaging (CT or MRI) and bone scan. (Clinical Principle)
  • Clinicians should recommend radical prostatectomy or radiotherapy plus ADT as standard treatment options for patients with high-risk localized prostate cancer. (Strong Recommendation; Evidence Level: Grade A)
  • Clinicians should not recommend active surveillance for patients with high-risk localized prostate cancer. Watchful waiting should be considered only in asymptomatic men with limited life expectancy (≤5 years). (Moderate Recommendation; Evidence Level: Grade C)
  • Cryosurgery, focal therapy, and HIFU treatments are not recommended for men with high-risk localized prostate cancer outside of a clinical trial. (Expert Opinion)
  • Clinicians should not recommend primary ADT for patients with high-risk localized prostate cancer unless the patient has both limited life expectancy and local symptoms. (Strong Recommendation; Evidence Level: Grade
  • Clinicians may consider referral for genetic counseling for patients (and their families) with high-risk localized prostate cancer and a strong family history of specific cancers (eg, breast, ovarian, pancreatic, other gastrointestinal tumors, lymphoma). (Expert Opinion)

Did this answer your question?
Additional feedback? (Optional)
Thank you for your feedback!