Other medical conditions can affect cancer progression during active surveillance

This study examined the relationship between comorbidities (other medical conditions) and cancer progression during active surveillance. Researchers reported that progression is more likely among men with 2 or more comorbidities. 

Active surveillance of prostate cancer refers to actively monitoring tumor growth without actually administering treatment. Active surveillance minimizes over-treatment in cases of low-risk prostate cancer. Preventing over-treatment is particularly important for men with shorter life expectancies. Over-treatment should also be avoided when other medical conditions (also called comorbidities) are present.

However, there is increasing evidence to suggest that comorbidities may increase the risk of cancer progression or recurrence. Some of these include obesity, diabetes, smoking, and high blood pressure. Whether comorbidities affect the progression of low-risk prostate cancer during active surveillance has not been fully studied.

This study examined the records of 29,447 men with low-risk prostate cancer. All men received treatment with prostate surgery and were undergoing active surveillance. 1.5% of men had 2 or more comorbidities.

Overall, 9.6% of men were upgraded to higher-risk disease during active surveillance. Men with 2 or more comorbidities were 1.4 times more likely to have their cancer upgraded. Disease progression was also more likely among older men (aged 70 years or more) and non-white men. Other contributing factors included blood and biopsy results. Comorbidities remained a strong predictor of progression in young white males, even after controlling for these factors. 

Researchers concluded that comorbidities can increase the likelihood of low-risk prostate cancer progressing during active surveillance.