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Re: A Question for John Bonneville

Alan I am not adverse to the use of AS in the management of PCa in suitable candidates. Below is an extract of the criteria for AS applicable in Australia, which I happen to agree with;

"Patients with low risk disease: men with low volume malignancy (one of four cores positive or less) of Gleason score 3+3 with a PSA of less than 10 ng/mL on presentation and either a non-palpable tumour on DRE or a small tumour occupying less than half of one lobe (stage T1c–T2a)"

Needless to say, we are talking about very early stage low risk disease.

The other indicator for AS in my view is a life expectancy of less than 10 years. Co-morbidity is of course another mitigating factor.

I trust this clarifies my position for AS for you.

best wishes
john

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