EAU 2021: Patient Statement: Active Surveillance

(UroToday.com) Mr. Cosimo Pieri from Italy kicked off the session on active surveillance for intermediate risk prostate cancer with a patient testimonial. As mentioned made the session chairs, he has been a strong proponent of active surveillance in Italy, Europe, and even internationally.


Mr. Pieri notes that he is the General Secretary of EuropaUomo, a European advocacy movement for men with prostate cancer, representing 27 national patients’ groups. Their website is https://www.europa-uomo.org/. He is also a board member of the central office.

Mr. Pieri Initially presented to his urologist with lower urinary tract symptoms (LUTS) and was treated successfully with medical management. Ultimately, he underwent a TURP or outlet procedure for his urinary symptoms and responded well.

His urologist continued him on PSA monitoring. Approximately 5 years later, he was felt to have an abnormal rectal exam with a palpable nodule. PSA went to 1.3 from 0.7. Based on this, he underwent an MRI and fusion biopsy and was diagnosed with prostate cancer - GG1 prostate cancer, low risk. He was asymptomatic.

He was counseled on 3 treatment options – radiation therapy, prostatectomy, and active surveillance (AS). He notes that it was a balanced unbiased discussion and incorporated shared decision making. He opted for AS. He has remained on surveillance since then.

He does note the psychological effects within the 1st year of diagnosis about the lack of certainty and the anxiety associated with that. He strongly recommended patient counseling groups – to meet with other patients and allow for more time to process the diagnosis and management. The initial appt with specialist is often too short for patients.

He remains a strong proponent of active surveillance in Italy, Europe, and even nationally.

Presented by: Mr. Cosimo Pieri, General Secretary of EuropaUomo, Milan, Italy

Written by: Thenappan (Thenu) Chandrasekar, MD – Urologic Oncologist, Assistant Professor of Urology, Sidney Kimmel Cancer Center, Thomas Jefferson University, @tchandra_uromd on Twitter during the 2021 European Association of Urology, EAU 2021- Virtual Meeting, July 8-12, 2021.