New Study Finds Men with Early-Stage Prostate Cancer Can Delay Aggressive Treatments

A new study, published in the New England Journal of Medicine, has found that men with early-stage prostate cancer can safely delay more aggressive treatments. The study followed more than 1,600 men newly diagnosed with localized prostate cancer in the United Kingdom between 1999 and 2009.^[0]

Dr. Freddie Hamdy, the lead researcher from the University of Oxford, cautioned individuals diagnosed with localized prostate cancer to not be hasty or alarmed when it comes to making treatment decisions. ‘This is good news as it’s now clear that, unlike many other cancers, a diagnosis of prostate cancer should not be a cause for panic or rushed decision-making,’ said Professor Freddie Hamdy.

At a median follow-up of 15 years (range, 11 to 21), researchers compared the results in all three groups with respect to death from prostate cancer (the primary outcome) and death from any cause, metastases, disease progression, and initiation of long-term androgen-deprivation therapy (secondary outcomes).

By the end of 15 years, 22% of the men had died from all causes and 2.7% from prostate cancer. In the active monitoring group, 9% of the tumors had spread, as opposed to 4.5% in the treatment groups.^[1] The study found that patients’ risk of dying from the disease was low regardless of whether they were actively monitored or treated with radiation or surgery.^[2]

According to Dr. Matthew Hobbs, Director of Research at Prostate Cancer UK, it has been confirmed that for prostate cancer which grows slowly, active monitoring is safe and does not have the potential to reduce life expectancy. As a result, men have the option to put off surgery or radiotherapy, or even avoid them altogether.

The study noted that men in the active-monitoring group were nearly twice as likely to see their prostate cancer progress and spread than the men in the aggressive treatment groups.^[2] However, this progression didn’t lead to a higher likelihood of death, suggesting that “if men develop metastases, that doesn’t necessarily mean they will die of prostate cancer.”^[2]

Dr. Hamdy stressed that the findings do not apply to men at high risk of prostate cancer. Hamdy emphasized that high-risk patients require rapid and assertive treatments.^[2]

Overall, the study shows that men with early-stage prostate cancer can safely delay more aggressive treatments without compromising quality of life or longevity.

0. “Fifteen-Year Outcomes after Monitoring, Surgery, or Radiotherapy for Prostate Cancer | NEJM” nejm.org, 11 Mar. 2023, https://www.nejm.org/doi/pdf/10.1056/NEJMoa2214122

1. “Early prostate cancer study released on ‘active surveillance' benefits” USA TODAY, 11 Mar. 2023, https://www.usatoday.com/story/news/health/2023/03/11/early-prostate-cancer-study-released-active-surveillance-benefits/11446395002

2. “Prostate cancer study shows some men can avoid, delay aggressive treatments” The Washington Post, 13 Mar. 2023, https://www.washingtonpost.com/health/2023/03/12/men-prostate-cancer-treatment-study