Anxiety predicts decision to move from surveillance to treatment

What are your criteria for triggering intervention in prostate cancer patients undergoing surveillance?
Eric A. Klein, MD, of the Cleveland Clinic, had a simple, if unexpected, answer.

"Patient anxiety is number one. Active surveillance is not for everybody, and you?ve got to pick the right patients for it," Dr. Klein said. Peter Carroll, MD, concurred.

"One-third of the men in our series who undergo treatment do so because of anxiety, not because of any change in cancer grade or volume. We've found something called 'anxiety velocity' that will be published shortly. When you measure anxiety, it independently predicts for treatment, even when you control for PSA, " Dr. Carroll said.