Prostate cancer is the second-most common cancer for men in our country, topped only by skin cancer. Best guesstimate is that 288,000 men will get the disease this year.
It’s not difficult for doctors to diagnose the illness, but deciding whether to treat it right away or take a wait-and-see approach has been open to debate. A new study published in the New England Journal of Medicine offers men a little more guidance.
The prostate is a walnut-sized gland that is part of the male reproductive system. Researchers have recently examined long-term evidence which shows that actively monitoring localized prostate cancer is a safe alternative to immediate treatment — whether that treatment is radiation or surgery.
Men diagnosed with localized prostate cancer may not need to panic or rush to make a treatment decision. However, the findings do not include patients who are at high-risk or have more advanced prostate cancer.
What this means is that men diagnosed with localized prostate cancer need not panic or rush to make a treatment decision. The lead author of the study, Freddie Hamdy of the University of Oxford, said that they should instead “consider carefully the possible benefits and harms caused by the treatment options.” Some of the side effects of treatment include urinary, bowel and erectile dysfunction.
For their study, the researchers followed more than 1,600 men from the UK who were diagnosed with prostate cancer and agreed to be randomly assigned to either surgery, radiation or just active monitoring. The other condition was that participants’ cancer needed to be confined to the prostate.
Men who were assigned to the monitoring group had regular blood tests. Some went on to have surgery or radiation.
At 15 years, the study found that the cancer had spread in:
- 9.4 percent of the active-monitoring group
- 4.7 percent of the surgery group
- 5 percent of the radiation group
There are two important take-aways from the results. First, the study was begun in 1999 and experts agree that today’s monitoring practices are much improved. Now there are MRI imaging and gene tests to help guide medical decisions. “We have more ways now to help catch that the disease is progressing before it spreads,” Stacy Loeb, an oncologist and Professor of Urology and Population Health at New York University Langone Health specializing in prostate cancer who was also involved in the research, said in a press release. About 60 percent of low-risk patients presently choose monitoring which is now called “active surveillance.”
Loeb said the second take-away is that, “There was no difference in prostate cancer mortality at 15 years between the groups,” and prostate cancer survival for all three groups was high — 97 percent regardless of treatment. “That’s also good news,” she added.