Men with localized prostate cancer who delay treatment while receiving regular monitoring have the same high survival rate as those who receive prompt surgery or radiation. Prostate cancer typically grows slowly, and most men with the malignancy do not die from it.
In a study of 1,643 men with early prostate cancer, about 97% were still alive 15 years after diagnosis regardless of whether they were randomized to receive surgery, radiation plus hormone therapy or active monitoring. Men in the latter group were more likely to experience disease progression, but this did not lead to higher mortality. Delaying or skipping treatment let patients avoid side effects, such as urinary incontinence and sexual problems.
“Patients and clinicians can and should take their time to weigh up the benefits and possible harms of different treatments in the knowledge that this will not adversely affect their survival,” says Freddie Hamdy, MD, of the University of Oxford.