SEP 18, 2016 10:48 AM PDT

For Early Prostate Cancer, it's Safe to Watch and Wait

WRITTEN BY: Xuan Pham
For men with early stage prostate cancer, opting for active surveillance may result in the same survival benefits as invasive surgery or radiotherapy. The newest study is the first to make such comparison over 10 years, and results underscore the risks of overtreatment for this condition.
 

Prostate cancer represents a huge health risk – it is the most common form of cancer in men. In 2013, nearly 2.8 million men were living with prostate cancer in the US. Fortunately, prostate cancer has one of the better 5-year survival rates at 98.9 percent.
 
However, must all men be treated with aggressive therapies to see this survival outcome? "It's understandable, if a 55-year-old man is told they have cancer, and they have a family, they don't want to take any risks,” said Freddie Hamdy, professor at the University of Oxford, and first author of the study.
 
Yet, in their study of 1,643 men with prostate cancer, the group that received active surveillance (no radical cancer treatment) had nearly the same survival rate over 10 years as those received surgery or radiation.
 
“Virtually no one had died from prostate cancer,” said Mark Litwin, chair of urology at the David Geffen School of Medicine at UCLA, who was not involved in the research. “That is a really striking finding: All three groups have almost 100 percent surviving. That should give all men pause before pursuing radical treatment for low- or intermediate-risk tumors.”
 
Prostate cancer need not necessarily be treated with surgery or radiotherapy

Of note, the American Society of Clinical Oncology recommends surveillance for men with localized, low-grade prostate cancer diagnoses. And while many doctors also share this same belief, it is contrary to what most people believe about cancer treatment. That is, most people with cancer want to get rid of the cancerous tumors as soon as possible – letting it live inside their bodies could seem like waiting for a time bomb to explode.
 
But consider that surgery and radiotherapy carry hefty costs, too. In the study, a large portion of men (46 percent) treated with surgery were wearing adult diapers six months after the procedure. Furthermore, men treated with radiation and surgery were less likely to sustain an erection, as compared to the monitoring group.
 
It’s important to note that active surveillance doesn’t mean nothing is done. These men had regular biopsies, blood tests for prostate-specific antigen levels, and MRI scans to monitor cancer progression.
 
"At the moment, many men decide against active surveillance because of the uncertainty about the impact of that choice and the anxiety it causes. It is extremely reassuring to hear that, when it is performed to a high standard, active surveillance gives men the same chance of survival,” said Matthew Hobbs, from the charity Prostate Cancer UK.
 
Additional sources: Stat News, BBC
About the Author
  • I am a human geneticist, passionate about telling stories to make science more engaging and approachable. Find more of my writing at the Hopkins BioMedical Odyssey blog and at TheGeneTwist.com.
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