A new study offers important information to men who are facing difficult decisions about how to treat early prostate cancer, or whether to treat it at all. Researchers followed patients for 10 years and found no difference in death rates between men who were picked at random to have surgery or radiation, or to have "active monitoring" of the cancer, with treatment only if it progressed.
Death rates from the cancer were low: only about 1 percent of patients at 10 years.
But the disease was more likely to progress and spread in the men who opted for monitoring rather than for early treatment, and by the end of 10 years, about half the patients in the study who had started out being monitored wound up having surgery or radiation.
The study, published Wednesday in the New England Journal of Medicine, was the first to include detailed information from patients about the side effects of treatment. Men who had surgery to remove the prostate were the most likely to have lingering problems with impotence and incontinence.
But there were no differences among the three groups in anxiety, depression or their feelings about how their health affected their quality of life.
Doctors say the findings should help reassure men who choose treatment that, based on the 10-year survival figures, surgery and radiation are equally reasonable choices for early prostate cancer.
Dr. Peter T. Scardino, a prostate surgeon and chairman of the department of surgery at Memorial Sloan Kettering Cancer Center in New York who was not involved in the study, said that an important message from the study is that early prostate cancer is not an emergency, and men have time to decide what to do about it.