A clinical trial recently found out that if people delay treatment for their localized prostate cancer, it doesn’t take away the possibility of living a long life.
This study surveyed the biggest amount of data yet and came to the same conclusion: even fifteen years after being diagnosed with prostate cancer, if you chose to actively monitor your condition instead of choosing radiotherapy or surgery, your chances of survival stays high.
These findings were reported on March 11 at the European Association of Urology’s yearly meeting in Milan and was also published in the New England Journal of Medicine.
The National Institute for Health and Care Research did a test to find out if men with cancer were more likely to survive if they had radiotherapy or surgery compared to just doing regular tests.
It turned out that the risk of their cancer progressing was greater when only doing regular testing, but the survival rate stayed the same.
Additionally, it showed that negative side effects from radiotherapy or surgery like pain when peeing or losing sexual function may last up to 12 years.
A study done by Professor Freddie Hamdy from the University of Oxford shows that if you are diagnosed with low or medium-risk prostate cancer, it’s okay to take some time to decide on a treatment plan.
The doctor said that if you have prostate cancer, you don’t need to be very scared or rushed into making any decisions. You can take your time in thinking about the pros and cons of different treatments. Also, no matter how long it takes for you to decide which treatment fits your situation best, it won’t affect your chances of surviving.
The experiment happened at nine different places in the UK, and it was the longest research of its type. It was also the first study where researchers looked closely into 3 important treatments for people with prostate cancer that hadn’t spread: active monitoring, surgery, and radiotherapy plus medicines.
Between 1999 and 2009, 1,643 men aged between 50-69 years across the UK were diagnosed with prostate cancer after taking a PSA blood test. Of these men, 545 agreed to be monitored by scientists, 553 underwent surgery and another 545 had radiotherapy. Scientists tracked these men for 15 years to measure how many died, whether their cancer grew or spread and what effect the treatment had on their quality of life.
97% of men with prostate cancer stayed alive for 15 years after diagnosis no matter what kind of treatment they got. 25% of people who were observing their cancer instead of treating it still did not have surgery/treatment 15 years later.
People in all 3 groups said that their physical and mental wellbeing was about the same. However, it was discovered that the surgery or radiotherapy resulted in negative problems with peeing, pooping and sexuality that lasted longer than what people had originally thought.
In 2016, researchers figured out that after 10 years, guys with a certain kind of cancer were twice more likely to have it get worse or spread compared to those in other groups. People thought this could mean those guys would not live as long. But the results from 15 years show that is not true, and everyone’s survival rate is about the same.
Professor Freddie Hamdy said that this is great news for men with prostate cancer. People who don’t do treatments to get rid their cancer and even those who have cancer that has spread aren’t in big trouble, since they will likely live a long time. So, it’s not important to go ahead with treatments right away and some may even be harmful.
There is a small group of men who have the most serious type of illness, and nothing we know can help them. We need to learn how to recognize these cases earlier on, and also find treatments that work for them.
Professor Jenny Donovan from the University of Bristol said that patients and doctors have helpful information about the side effects of treatments. This information can help them to make a choice between the treatment options. Survival is no longer a factor, so men diagnosed with prostate cancer can choose which treatment works best for their preferences and values.
The trial discovered faults in the way doctors decide which prostate cancers may quickly grow and spread. Researchers found that 77% of those involved in the study were originally viewed as low risk. But, after looking at the results with better methods, nearly all of them had a higher grade and stage of disease than thought before. Even though many had a more severe cancer than initially believed, few of the participants died from their prostate cancer. Sadly, some who passed away were labeled as low risk when first diagnosed, so this is an issue that needs attention.
Professor Peter Albers, who is the head of the EAU’s Scientific Congress Office and a doctor from Düsseldorf University, said that people should not be fearful about delaying treatment for prostate cancer. He added that today’s treatments are much more advanced than before so it is possible to improve on outcomes even further. He also mentioned that delaying treatment means less side effects as well.
We still don’t fully understand which cancers can be the most dangerous, and so we need to do more research on this as soon as possible.
The ProtecT Study Group did a research that tracked the outcomes of prostate cancer treatment over fifteen years. The research was published in the New England Journal of Medicine and included doctors named Freddie C. Hamdy, Jenny L. Donovan, J. Athene Lane and 14 other doctors who are all experts in this field. Their findings showed that by monitoring, doing surgery or radiation therapy, it is possible to manage prostate cancer effectively in the long run.
The EAU23 European Association of Urology Annual Congress is getting funded by the National Institute for Health Research.
