Active surveillance recommended for low-risk prostate cancer

For most men with low-risk prostate cancer, Active Surveillance (AS) with regular testing to check for cancer growth instead of immediate curative treatment like surgery or radiotherapy leads to a better overall quality of life, as per a recent study.

In fact, the Quality of life (QoL) is about the same as for men who do not have cancer.

Detailed questionnaires followed the quality of life of 427 patients (out of the 628 originally contacted), aged between 66-69 who were diagnosed with low-risk prostate cancer and were followed up for between 5 and 10 years after initial diagnosis. 121 of the patients chose active surveillance, whereas 74 had surgery and 232 had radiotherapy. A reference group of 204 men of the same ages who didn't suffer from prostate cancer were also studied.

Lead author Dr Lionne Venderbos from Erasmus University Medical Center said that they found that men on active surveillance experienced better prostate-related health than men who underwent radical prostatectomy and radiotherapy. This showed up as better urinary function, less urinary incontinence and better sexual function.

Furthermore, he added that they found that the quality of life of men on active surveillance was similar to a group of men without prostate cancer. This is interesting because men on active surveillance still live with untreated cancer as compared to men in the reference group who do not have cancer. The monitoring combined with information on the low-risk nature of men their disease may partly explain the similar quality of life.

Venderbos further said that when choosing treatment, it is important that men think about the potential side-effects that are related to immediate curative treatment, like becoming incontinent or losing the ability to have an erection. When considering active surveillance they should try to imagine whether living with untreated cancer would cause any stress or that the follow-up visits lead to stress instead of reassurance. Balancing the advantages and disadvantages per type of treatment, will make that a man choose that type of treatment that fits his wishes and preferences best.

The study is presented at European Association of Urology 2016, Munich.