March 25, 2023


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According to a study, delaying prostate cancer treatment does not increase the risk of death

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It has been shown through a study led by researchers from the universities of Oxford and Bristol, that delaying the treatment of prostate cancer does not increase the risk of mortality. It was presented at the European Association of Urology (EAU) Congress in Milan (Italy) and published in the New England Journal of Medicine.

However, men under active surveillance, which included regular tests to detect the cancer, were more likely to see progression or spread than those who received radiation therapy or surgery, did not reduce their chances of survival.
In addition, the study found that the negative effects of radiation therapy and surgery on urinary and sexual function last much longer than previously thought, up to 12 years.


More time to discuss the various treatments

According to lead investigator Professor Freddie Hamdy of the University of Oxford, the results show that treatment decisions should not be rushed after a diagnosis of localized low- and intermediate-risk prostate cancer.

“Unlike many other types of cancer, it is clear that a diagnosis of prostate cancer should not be a reason for panic or hasty decisions,” he said. “Patients and clinicians can and should take the time to consider the benefits and potential harms of different treatments, knowing that it will not affect their survival,” he added.

The study was conducted at nine centers in the UK and is the longest running study of its kind. It is the first to fully evaluate three main treatment options: active surveillance, surgery (radical prostatectomy), and radiation therapy with hormones for men with localized prostate cancer.

Between 1999 and 2009, 1,643 men aged 50-69 in the UK diagnosed with localized prostate cancer, after a PSA blood test, consented to randomized active surveillance (545), radical prostatectomy (553) or radical radiotherapy (545). The research team followed the men for an average of 15 years to measure death rates, the progression and spread of the cancer, and the impact of the treatments on quality of life.


Effects after surgery and radiotherapy
They found that about 97% of men diagnosed with prostate cancer survived 15 years after diagnosis, regardless of the treatment they received. About a quarter of the men under active surveillance had not received invasive treatment for their cancer after 15 years.

Patients in all three groups reported a similar general quality of life in terms of their general physical and mental health. However, the negative effects of surgery or radiation therapy on urinary, bowel, and sexual function have been found to last much longer than previously thought.

In earlier findings published in 2016, the researchers found that after 10 years of follow-up, men whose cancer was actively monitored were twice as likely to progress or metastasize than men in the other groups. The assumption was that this could lead to a lower survival rate for males with active surveillance for a longer period of time. However, the results of the 15-year follow-up show that this is not the case and that survival rates remain equally high in all groups.

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