Treatments for prostate cancer: reports of 10-year outcomes

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Prostate cancer occurs when abnormal cells develop in the prostate. These abnormal cells can continue to multiply in an uncontrolled way and sometimes spread outside the prostate into other parts of the body.

Generally, prostate cancer is a slow growing disease. Although the majority of men with prostrate cancer can live for many years with no symptoms, it could be life threatening.

In the USA, it is estimated that 180,890 men will be diagnosed in 2016, and 26,120 men will die from the disease.

The widespread use of prostate cancer testing methods is prostate-specific antigen (PSA), which increases the diagnosis and treatment of prostate cancer. So far it is not clear whether people benefit from the intervention.

In a study newly published in The New England Journal of Medicine, researchers reported the 10-year outcomes after active monitoring, surgery or radiotherapy of prostate cancer.

Researchers from University of Oxford, University of Bristol, Cardiff University, University of Edinburgh, University of Cambridge, and several main hospitals in England conducted the study.

Researchers compared active monitoring, radical prostatectomy, and radiotherapy for the treatment of clinically localized prostate cancer.

Between 1999 and 2009, 82,429 men (50-69 years old) who received a PSA test, about 2,664 got a diagnosis of prostate cancer. About 545 agreed to undergo active monitoring, 553 agreed to do surgery, and 545 agreed to do radiotherapy.

The result showed that 17 men died from prostate-cancer specific deaths: 8 in the monitoring group (0.14%), 5 in the surgery group (0.09%), and 4 in the radiotherapy group (0.04%).

Metastases (i.e. cancer cells break away from where they first formed, travel through blood to other parts of the body and form new tumors) developed in more men in the active-monitoring group (0.63%) than in the surgery (0.24%) or the radiotherapy group (0.3%).

In addition, higher disease progression was seen in the active-monitoring group (2.3%) than in the surgery group (0.89%) or the radiotherapy group (0.9%).

Researchers suggest that the prostate-cancer death rate is low irrespective of the treatment used. Surgery and radiotherapy were related to lower disease progression and metastases than active monitoring.


Citation: Hamdy FC, et al. (2016). 10-Year Outcomes after Monitoring, Surgery, or Radiotherapy for Localized Prostate Cancer. New England Journal of Medicine, published online. doi:10.1056/NEJMoa1606220.
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