Research Confirms Safety of ‘Watch-and-Wait’ for Prostate Cancer

Prostate Cancer Tumor Grows so slowly in Males
Prostate Cancer Tumor Grows so slowly in Males. Credit | Getty images

United States: In many cases, the prostate cancer tumor grows so slowly in males that medical professionals recommend “watch-and-wait” treatment rather than aggressive therapy though this is something which seems unbelievable

According to a study conducted on nearly 2,200 patients who were monitored for up to ten years, most of them may have made the right choice.

Study Results

“In this study, 10 years after diagnosis, 49% of men remained free of progression or treatment, less than 2% developed metastatic disease and less than 1% died of their disease,” according to a team led by Lisa Newcomb. She works as a researcher in cancer prevention at Seattle’s Fred Hutchinson Cancer Center.

Safe Management Strategy

According to Newcomb, “our study showed that using active surveillance that includes regular PSA exams and prostate biopsies is a safe and effective management strategy for favorable-risk prostate cancer.”

Many, if not most, men who were recently diagnosed with prostate cancer a few decades ago were immediately sent for treatment, which usually involved hormone-suppressive medications and/or surgery (prostatectomy).

A man’s quality of life may be significantly impacted by the adverse effects of either of these procedures, which include impotence and urinary problems.

Changing Perspectives

All that has altered, though, in the last 20 years, as new discoveries about the diverse nature of prostate cancers have emerged.

In contrast to so-called “indolent” cancers, which grow very slowly, doctors can now identify aggressive, rapidly growing tumors that could represent an immediate threat based on specific testing.

In cases involving older men, especially, indolent tumors may not be as serious a threat to health to health as other conditions, such as heart disease.

A “active surveillance” strategy to treatment is now being offered to many people with prostate cancer as a result of all of this.

In this case, there is no medical intervention. Rather, patients are requested to undertake testing on a regular basis to see whether a suspected “indolent” tumor has developed into something more serious.

However, to what extent does this tactic actually contribute to men’s long and healthy lives?

Newcomb et al. examined the most recent data from a research initiated in 2008 to monitor the prognosis of prostate cancer.

Long-Term Monitoring

2,155 men “with favourable-risk prostate cancer and no prior treatment” receiving care at one of ten facilities in North America were included in the study.

Up to ten years were spent monitoring the men’s health (the average follow-up was 7.2 years). When the data was gathered, 83% of them were White, and their average age was 63. When they started the trial, nearly all (90%) had been diagnosed with a grade 1 prostate tumor, which is a less dangerous condition.

According to biopsy results, 43% of the men did have a change in their tumor status after ten years of diagnosis; these men were then referred for therapy, according to the researchers. In this group, 11% of patients had a tumor recurrence.

But the first “watch-and-wait” approach seems to have worked: of the initial cohort, nearly half never required active treatment, and only a small percentage ever developed metastatic disease.

National Acceptance

A journal news release attributed to Newcomb stated, “An important finding was that adverse outcomes, like recurrence or metastasis, do not seem worse in people treated after several years of surveillance versus one year of surveillance, alleviating concern about losing a window of curability.”

She continued, “We hope that this study encourages the national acceptance of active surveillance for prostate cancer in place of immediate treatment.”