Prostate Cancer Treatment Can Wait for Most Men, Study Finds

A recent study has found that active­ly mon­i­tor­ing local­ized prostate can­cer is a safe alter­na­tive to imme­di­ate surgery or radi­a­tion. The research pro­vides long-term evi­dence that mon­i­tor­ing is a viable option for men who want to avoid treat­ment-relat­ed sex­u­al and incon­ti­nence problems.

The study direct­ly com­pared the three approach­es — surgery to remove tumors, radi­a­tion treat­ment, and mon­i­tor­ing — and found no dif­fer­ence in prostate can­cer mor­tal­i­ty at 15 years between the groups. Prostate can­cer sur­vival for all three groups was high at 97%, regard­less of treat­ment approach.

Lead author Dr. Fred­die Hamdy of the Uni­ver­si­ty of Oxford advis­es men diag­nosed with local­ized prostate can­cer to care­ful­ly con­sid­er the poten­tial ben­e­fits and harms of the var­i­ous treat­ment options. 

The study fol­lowed over 1,600 UK men who were ran­dom­ly assigned to receive surgery, radi­a­tion, or active mon­i­tor­ing. The patients’ can­cer was con­fined to the prostate, and the mon­i­tor­ing group had reg­u­lar blood tests with some going on to have surgery or radiation.

Hamdy notes that a small num­ber of men with high-risk or more advanced dis­ease do require urgent treat­ments. How­ev­er, for most men, there is no need to pan­ic or rush treat­ment decisions. 

The study’s results were pub­lished in the New Eng­land Jour­nal of Med­i­cine and pre­sent­ed at a Euro­pean Asso­ci­a­tion of Urol­o­gy con­fer­ence in Milan, Italy. The British Nation­al Insti­tute for Health and Care Research fund­ed the research.

The study’s find­ings are encour­ag­ing for men who want to avoid treat­ment-relat­ed side effects. In the U.S., about 60% of low-risk patients choose mon­i­tor­ing, now called active surveillance. 

Today’s mon­i­tor­ing prac­tices are bet­ter, with MRI imag­ing and gene tests guid­ing deci­sions. The researchers expect­ed to see a dif­fer­ence in sur­vival at 15 years due to the dif­fer­ence in can­cer spread at 10 years, but did not. How­ev­er, the find­ings are use­ful for men when mak­ing deci­sions about treatments.

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