Research Finds Monitoring Better Than Active Treatment for Low-Risk Prostate Cancer

Men with low-risk prostate cancer on active surveillance report fewer problems with sexual function than those on other treatments.

New research has found that men over 60 years of age with low-risk prostate cancer could spend 10 years with no active treatment, enabling them to have a better sex life and lower risk of mortality from the disease, according to a press release from a pair of studies presented at the European Association of Urology congress.

The first study uses data from Sweden’s National Prostate Cancer Register, which consists of information on virtually every man diagnosed with the disease in the country since 1998 and 23,649 who are on active surveillance. This type of surveillance was introduced approximately 20 years ago for men with low-risk prostate cancer, which coincides with the limited data on risks and benefits over a longer time period.

Researchers identified how many patients moved from active surveillance to other treatments, such as radiotherapy or surgery, which allowed them to model the likely outcomes for men on active surveillance up to 30 years from diagnosis based on the numbers moving onto different treatments. This process showed the percentage of men who would die from prostate cancer and the number of years spent without treatment post-diagnosis, according to the study authors.

"Obviously, the older you are and the lower risk your cancer, the greater the benefit. But we saw a real divide at age 60. Men diagnosed under 60 on active surveillance have a greater likelihood of dying of prostate cancer with very little added benefit, in terms of extra years with no other treatment,” said urologist Eugenio Ventimiglia in the press release. “After 60, if your cancer is low-risk, then active surveillance is really a win-win: the model showed men having ten years or more without other treatment with only a low percentage likely to die from the disease."

Existing treatments for prostate cancer, such as radiotherapy or surgery, can result in incontinence and erectile dysfunction, whereas the physical adverse effects of active surveillance are minimal. Men on active surveillance report fewer problems with sexual function than those on other treatments, according to the presentation.

The research uses data from the Europa Uomo Patient Reported Outcome Study (EUPROMS) study, which is the first prostate cancer quality of life survey conducted by patients for patients. Approximately 3000 men from 24 European countries diagnosed with prostate cancer have completed the survey, which showed that 45% of men on active surveillance reported problems having an erection compared to between 70% and 90% of men on other treatments.

"This is important for men diagnosed with prostate cancer to be aware of, before they decide which treatment option to pursue,” said Lionne Venderbos, analyzer of the survey results, in a press release. “Men who choose active surveillance as their preferred option have the same survival rates over five years as those who chose surgery or radiation, but can also maintain sexual function."

REFERENCE

Monitoring proves better than active treatment for low-risk prostate cancer. EurekAlert! July 11, 2021. Accessed July 12, 2021. https://sciencesources.eurekalert.org/pub_releases/2021-07/eaou-mpb070821.php