Active monitoring of prostate cancer is as good an option as surgery or radiation treatment, according to a comparative effectiveness study in the New England Journal of Medicine. There was no difference in death rates for men picked at random over a 10-year period for surgery, radiation, or active monitoring. That said, the cancer was more likely to progress in patients who picked active monitoring rather than surgery or radiation treatment. In addition, about half of the patients who had started out being monitored wound up having surgery or radiation.
Active monitoring allows patients to avoid the side effects of surgery or radiation treatment, including impotence and urinary incontinence. “At a median of 10 years, prostate-cancer–specific mortality was low irrespective of the treatment assigned, with no significant difference among treatments,” the study states. “Surgery and radiotherapy were associated with lower incidences of disease progression and metastases than was active monitoring.”
Active monitoring involves regular exams of the prostate, as well as periodic PSA tests.