Monitoring has proven to be superior to aggressive treatment for low-risk prostate cancer

Men over the age of 60 with low-risk prostate cancer can spend 10 years without aggressive treatment, resulting in a better sex life but still dying from the disease New research shows that it is very unlikely.

The findings are from two new studies:Active monitoring‘of Prostate cancer— If the disease is closely monitored but not treated — announced today at the European Association of Urology conference, EAU21.

The first uses data from the Swedish National Prostate Cancer Registry. This registration contains information about almost all men who have been diagnosed with the disease in Sweden since 1998. Of these, 23,649 are still active. Surveillance..

Active surveillance was introduced for men 15 to 20 years ago Low-risk prostate cancer, There are no data on long-term risks and benefits yet. Researchers at Uppsala University and Gothenburg University have devised new statistical methods to fill this gap.

Rather than just looking at the number of patients who have died in the prostate and are under active surveillance cancer, They identified the number of people who moved from active surveillance to other treatments such as radiation therapy and surgery. Since these treatments have been provided for many years, long-term follow-up data on them already exist.

This allowed researchers to model possible outcomes in men with active monitoring from diagnosis to up to 30 years, based on the number of transitions to different treatments. They were able to show not only the percentage of men who died of the disease during that period, but also the number of years spent without post-diagnosis treatment.

A urologist at the San Rafaele Hospital in Milan (Italy) and a PhD student from the Department of Surgery at Uppsala University (Sweden) explains: “I wanted to identify the true winner from active surveillance. A man who is unlikely to die of prostate cancer but spends most of the rest of the year untreated. If the disease is carefully monitored. ..

“Obviously, the older you are and the lower your risk of cancer, the greater the benefits. However, at age 60, you saw actual division. Men who were diagnosed under 60 by active surveillance, Prostate cancer is more likely to die and has little additional benefit, in terms of extra years without other treatments. After age 60, if the risk of cancer is low, active surveillance really wins Win. Models show that men who haven’t received other treatments have been around for more than 10 years and are unlikely to die of illness. “

Less impact Sexual function

Other treatments for prostate cancer, such as radiation therapy and surgery, can cause incontinence and erectile dysfunction, but the physical side effects of active monitoring are minimal. Other studies published today at EAU21 report that men under active surveillance have fewer sexual function problems than men receiving other treatments.

This study utilizes data from the Europa Uomo Patient Reported Outcome Study, the first quality of life study of prostate cancer performed by patients on their behalf. A little less than 3,000 men from 24 European countries diagnosed with prostate cancer completed the survey at home at their own time. This gives you more time to review your answers and report how you actually feel, compared to a questionnaire conducted in a clinical environment.

Studies show that less than 45% of men under active surveillance report erection problems, compared to 70-90% of men receiving other treatments.

Lionne Venderbos, a postdoctoral fellow at Erasmus MC in Rotterdam, who analyzed the findings, said: Of all possible treatment options.

“It’s important to know this before deciding which treatment option a man diagnosed with prostate cancer should pursue. Men who choose active surveillance as a priority option choose surgery or radiation. They have the same 5-year survival rate as men who have had surgery, but they can also maintain sexual function. “

Hendrick van Poppel, Professor Emeritus of Urology at the Catholic University of Belgium in Leuven and a member of the EAU Executive, said:Show, active surveillance has the least negative impact, but it’s Treatment options Only possible if the disease is diagnosed early. Early detection of the disease is very important and active monitoring options should encourage men to overcome their resistance to being tested. prostate cancer. Prostate cancer can be fatal, but the later the diagnosis, the more severe the treatment and the greater the impact on quality of life. ”