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In the only randomised trial to compare active monitoring, surgery and radiotherapy for PSA-detected localised prostate cancer, deaths from prostate cancer were rare and equal at ten years in all three groups, though monitoring led to more metastases and progression.
Phase 3 trial of 1,643 men with PSA-detected localised prostate cancer randomised to active monitoring, radical prostatectomy or radiotherapy with six months of androgen deprivation.
Prostate cancer-specific mortality at ten years was about 1 percent in every group (17 deaths in total), while metastases (6.3 versus 2.4 and 3.0 per 1,000 person-years) and clinical progression were more frequent with monitoring; patient-reported outcomes showed distinct side-effect patterns for each treatment.
Most men with low- and favourable intermediate-risk prostate cancer can safely choose monitoring, and treatment choice should weigh urinary, sexual and bowel side effects against a small difference in progression.
Shares SPCG-4: radical prostatectomy or watchful waiting in prostate cancer, 29-year follow-up, PIVOT: follow-up of prostatectomy versus observation for early prostate cancer, ProtecT, Localised prostate cancer, very low and low risk.
Shares SPCG-4: radical prostatectomy or watchful waiting in prostate cancer, 29-year follow-up, Localised prostate cancer, very low and low risk, Localised prostate cancer, intermediate risk, Prostate cancer roadmap: from Huggins and the discovery that a cancer can depend on a hormone, through the PSA epidemic and what it cost, the androgen receptor drugs, the DNA repair subset and PSMA, to a 2032 registry watch.
Shares ProtecT, Localised prostate cancer, very low and low risk, Localised prostate cancer, intermediate risk, Prostate cancer.
Shares PIVOT: follow-up of prostatectomy versus observation for early prostate cancer, Localised prostate cancer, very low and low risk, Prostate cancer roadmap: from Huggins and the discovery that a cancer can depend on a hormone, through the PSA epidemic and what it cost, the androgen receptor drugs, the DNA repair subset and PSMA, to a 2032 registry watch, Prostate cancer.
Shares ProtecT, Localised prostate cancer, very low and low risk, Localised prostate cancer, intermediate risk, Prostate cancer.
Shares Localised prostate cancer, very low and low risk, Localised prostate cancer, intermediate risk, Prostate cancer roadmap: from Huggins and the discovery that a cancer can depend on a hormone, through the PSA epidemic and what it cost, the androgen receptor drugs, the DNA repair subset and PSMA, to a 2032 registry watch, New England Journal of Medicine.
Shares ProtecT, Localised prostate cancer, very low and low risk, Localised prostate cancer, intermediate risk, Prostate cancer.
Shares ProtecT, Localised prostate cancer, very low and low risk, Localised prostate cancer, intermediate risk, Prostate cancer.