Study: Prostate cancer treatment can wait for most
Researchers have recently found long-term evidence that actively monitoring localized prostate cancer is a safe alternative to immediate surgery or radiation.
The results are encouraging for men who want to avoid treatment-related sexual and incontinence problems, said Dr. Stacy Loeb, a prostate cancer specialist at NYU Langone Health who was not involved in the research.
The study compared the three approaches: surgery to remove tumors, radiation treatment and monitoring. Most prostate cancer grows slowly, so it takes years to look at the disease’s outcomes.
“There was no difference in prostate cancer mortality at 15 years between the groups,” Loeb said. And prostate cancer survival for all three groups was high — 97% regardless of treatment approach.
The results were recently published in the New England Journal of Medicine. Britain’s National Institute for Health and Care Research paid for the research.
Men diagnosed with localized prostate cancer shouldn’t panic or rush treatment decisions, said lead author Dr. Freddie Hamdy of the University of Oxford. Instead, they should “consider carefully the possible benefits and harms caused by the treatment options.”
A small number of men with high-risk or advanced disease do need urgent treatments, he added.
Researchers followed more than 1,600 U.K. men who agreed to be randomly assigned to get surgery, radiation or active monitoring. The patients’ cancer was confined to the prostate, a walnut-sized gland that’s part of the reproductive system. Men in the monitoring group had regular blood tests and some went on to have surgery or radiation.
Death from prostate cancer occurred in 3.1% of the active-monitoring group, 2.2% in the surgery group and 2.9% in the radiation group, differences considered statistically insignificant. At 15 years, cancer had spread in 9.4% of the active-monitoring group, 4.7% of the surgery group and 5% of the radiation group.