Monitoring, Not Treatment, May Be Better for Some Prostate Cancer Patients

More than 90% of men in Sweden who have very low-risk prostate cancer choose close monitoring rather than immediate treatment – and more American men should use that option, researchers say.

In a study of nearly 33,000 Swedish men with very low-risk (stage T1) prostate cancer diagnosed between 2009 and 2014, the number choosing what is called active surveillance increased from 57 to 91%.

“For men who are diagnosed with low-risk prostate cancer, it is important to know that active surveillance is an accepted way to manage the cancer,” said lead researcher Dr. Stacy Loeb. She’s an assistant professor in the departments of urology and population health at NYU Langone’s Perlmutter Cancer Center in New York City.

“There is no rush to get treatment – low-risk prostate cancer can be safely monitored,” she added. “Some men will eventually need treatment, but others will be able to preserve their quality of life for many years.”

In the United States, the majority of men with low-risk prostate cancer get treatment upfront, which can have side effects, such as urinary and erectile problems, Loeb said.

Active surveillance isn’t wait-and-see, she explained. It involves regular blood tests and regular biopsies to gauge the growth of the tumor. When the tumor grows to a point where treatment is needed, then it’s time for curative surgery or radiation.

The report was published online Oct. 20 in the journal JAMA Oncology.

A recent British trail showed that 10 years after diagnosis, the risk of dying from prostate cancer was the same whether men initially had surgery or radiation or opted for monitoring, Loeb added.