An older man speaks with a physician while sitting on an exam table in a doctor's officeShare on Pinterest
Experts say it’s important to monitor prostate cancer even if it isn’t being treated. mixetto/Getty Images
  • Experts say many men may be able to delay or avoid treatment for prostate cancer.
  • They say this is particularly true if the cancer is localized and in its early stages.
  • They add, however, it remains important to actively monitor prostate cancer even if it isn’t being treated.

Prostate cancer is the second most common cancer among men in the United States.

It is also the second leading cause of cancer death among men, behind only lung cancer.

Despite these statistics, less than 3% of men die from prostate cancer.

With that in mind, researchers in a new study say that most men who have localized prostate cancer – that is, cancer that does not spread outside the prostate – can avoid invasive treatments without affecting their chances of survival.

The study from the United Kingdom, which used data collected from the ongoing ProtecT clinical trial, was published this week in the New England Journal of Medicine.

The latest findings were also presented this week at the European Association of Urology meeting in Italy.

In the study, researchers said men who practice regular monitoring of prostate cancer have the same survival rates after 15 years as those who choose to do radiotherapy or surgery.

In a joint statement to Healthline, Dr. Freddie Hamdy, the study’s lead investigator and a professor at the University of Oxford in England, and Jenny Donovan, a professor of social medicine at the University of Bristol in England, said these findings are good news for people with prostate cancer.

Men newly diagnosed with localized, low or intermediate risk prostate cancer can now use the information from our study to weigh the benefits against the possible harms of radical treatments, and do not need to rush to take their decision,” they said.

An estimated 87% of all prostate cancers are detected when they are in the local or regional stages.

Many men diagnosed and treated in these early stages will be disease-free after five years.

The trial, funded by the National Institute for Health and Care Research, is the longest running study of its kind.

The trial is the first to fully evaluate three major prostate cancer treatment options: active monitoring, surgery (radical prostatectomy), and radiotherapy with hormones for men with localized prostate cancer.

Between 1999 and 2009, 1,643 men aged 50-69 years across the United Kingdom who were diagnosed with localized prostate cancer after a PSA blood test, agreed to be randomized to active monitoring (545), radical prostatectomy (553), or radical radiotherapy (545).

The researchers followed the men for an average of 15 years.

They reported that approximately 97% of the men diagnosed with prostate cancer survived 15 years after diagnosis, regardless of which treatment they received.

About a quarter of the men on active monitoring had still not had any invasive treatment for their cancer after a decade and a half.

Participants from all three groups reported similar overall quality of life, in terms of their general mental and physical health.

However, the negative effects of surgery or radiotherapy on urinary, bowel and sexual function were found to persist much longer than previously thought.

Dr. Aditya Bagrodia, an urologic oncologist and associate professor of urology disease at UC San Diego Health, is not involved this trial.

He told Healthline that this study doesn’t mean that people with prostate cancer, even if it is localized, should not continue to be closely monitored or offered treatment.

“When this clinical trial began, the headlines from… national publications were saying that this type of cancer has no impact on patient longevity,” Bagrodia said.

“That is what went out to the public, but no one mentions that prostate cancer remains a leading cause of death in men in the United States. And there was no mention that you have to stay vigilant and may ultimately require treatment in up to 60 percent of patients.”

Aditya said this study has a different message.

“It is absolutely critical to take into account a patient’s overall health, cancer characteristics, and priorities when making these highly individualized decisions on whether or not to treat prostate cancer,” he said.

According to the SEER Database of the National Cancer Institute, the 5-year survival rate for people with prostate cancer in the United States is 98%.

Approximately 87% of prostate cancers are found when the disease is only the prostate and/or nearby organs.

“Those facts diffuse a lot of the anxiety,” Aditya said. “This is very good news because it means that they are not dying any time soon and they can be thoughtful about treatment and monitoring. That means a combination of blood tests and imaging of the prostate with MRI and repeat biopsies to make sure it hasn’t progressed.”