Localized Prostate Cancer—New Study Findings on Active Monitoring versus Early Treatment

The large randomized Prostate Testing for Cancer and Treatment (ProtecT) study reported in two linked papers in the New England Journal of Medicine—has found that in low and intermediate risk disease radical prostatectomy and radiotherapy did not reduce prostate-specific or overall mortality after 10 years as compared with “active monitoring” but these treatments did reduce the spread of the disease.  Jenny Donovan, Professor of Social Medicine at Bristol University, describes the trade-off needed between side effects such as a 90 percent risk of sexual dysfunction and 50 percent chance of urinary incontinence which now need to be weighed against the potential of reducing risks beyond ten years.

www.nejm.org/doi/full/10.1056/NEJMoa1606220