Major hope for men with prostate cancer

Most men with prostate cancer are as likely to survive by being simply monitored compared with having radiotherapy or surgery, a British study has discovered.

Scientists who tracked more than 1,600 cancer patients for 15 years found no difference in the risk of death.

Instead, survival rates for men who chose active surveillance – blood tests and MRI scans every few months to make sure the tumour had not spread – were just as high as in those who underwent more invasive treatments.

Sir Ian McKellen, 83, is a case in point. The veteran British actor, who played the wizard Gandalf in the Lord Of The Rings movies, was diagnosed with slow-growing prostate cancer in 2006. He has had neither surgery nor radiotherapy, opting instead for frequent checks to make certain the cancer has not got worse.

Like him, all the men in the study had localised prostate cancer – tumours that had not spread to other parts of the body. These make up about 90 per cent of newly diagnosed cases.

The findings, presented today at the European Association of Urology (EAU) annual conference in Milan, have been hailed as a major breakthrough for patients. About 52,000 men in the UK are diagnosed with the disease each year.

‘This is good news as it’s now clear that, unlike many other cancers, a diagnosis of prostate cancer should not be a cause for panic or rushed decision-making,’ said Professor Freddie Hamdy from the University of Oxford, one of the lead investigators on the long-running ProtecT trial which is comparing different ways of dealing with the illness.

‘A quick decision on treatment is not necessary and could cause harm. Patients can take their time to weigh up the benefits and possible risks of different approaches in the knowledge that this will not adversely affect survival.’

Men diagnosed with localised tumours usually face a choice of active surveillance, radiotherapy to destroy the tumour or major surgery to remove the prostate, called a radical prostatectomy.

Many are tempted to choose immediate aggressive therapy to try to get on top of the disease as soon as possible, even though the side effects can be life-changing.

Men diagnosed with localised tumours usually face a choice of active surveillance, radiotherapy to destroy the tumour or major surgery to remove the prostate, called a radical prostatectomy. Many are tempted to choose immediate aggressive therapy to try to get on top of the disease as soon as possible, even though the side effects can be life-changing

Radiotherapy can cause hair loss, problems urinating and erectile dysfunction. Prostate surgery leaves about 85 per cent of men finding it difficult to obtain an erection and carries a risk of urinary incontinence.

The new study also shows that these damaging side effects last a lot longer than was previously thought – up to 12 years, instead of just a year or two.

Researchers’ earlier findings from 2016 showed cancers in men who opted for active surveillance were twice as likely to spread to other parts of the body, with the assumption this would result in higher death rates.

But the latest statistics show that now appears not to be the case: 97 per cent of men in the study were still alive 15 years after being diagnosed, irrespective of whether they had treatment or not.

Professor Peter Albers, chairman of EAU’s Scientific Congress Office, said: ‘It’s an important message for patients that delaying treatment is safe.’

Dr Matthew Hobbs, director of research at Prostate Cancer UK, said: ‘This confirms that for slow-growing prostate cancer, active monitoring is safe and unlikely to reduce life expectancy. Men can delay surgery or radiotherapy, or avoid them completely.’