Men diagnosed with localised prostate cancer shouldn’t go straight to radiotherapy or surgery - this is especially so as we know the side effects of those treatment are not great. I sadly wasn't in the 'localised' group but am delighted to see that this research will hopefully save many from treatment side effects if only for some years.
The study (i) showed little difference in survival across the 15 year study period from 1999. Death from prostate cancer occurred:
3.1% of the ‘Active Surveillance’ group,
2.2% of the surgery group,
2.9% of the radiation group.
These differences were considered to be statistically insignificant. This reminds me of a 2002 study that Chris Woollams of CancerACTIVE shared - in that they looked at over 50 men killed in car accidents in California and found that over 60% were driving around with prostate cancer, didn’t know it and weren’t receiving treatment. In other words from initial diagnosis, treatment was rarely urgent.
The study also found that at the end of the 15 year study, the prostate cancer had spread in
9.4% of the ‘Active Surveillance’ group,
4.7% of the surgery group
5% of the radiation group.
However the spread did not equate to significant survival differences. Having said all this it is clear we should consult with our medical team to find the best way forward.
Notes
(i) https://www.nejm.org/doi/10.1056/NEJMoa2214122
