For early prostate cancer, a watchful eye is just as good as treatment

Enlarge / A surgeon performs a robot-assisted prostate tumorectomy using ultrasound imaging. (credit: Getty | JEFF PACHOUD)

In the wake of a cancer diagnosis, deciding to sit back and see how things play out may seem like a ballsy move. But, if that diagnosis is for early-stage prostate cancer, it might be the smart one.

In a trial of 1,643 men diagnosed with early prostate cancer, those who actively monitored their cancer instead of immediately starting treatment had the same minuscule risk of death in a ten-year study as men who underwent either radiation therapy or surgery straightaway. The finding, reported Wednesday in the New England Journal of Medicine, suggests that it’s safe to hold off on the often slow-growing cancer when it's caught early and only seek treatments—which can have devastating side effects, including incontinence and impotence—if the disease progresses.

Disease progression (i.e. the cancer grows and spreads to other parts of the body) was more common among the 545 men randomly assigned to the monitoring group. About half ended up getting either radiation or surgery by the end of the ten-year study. However, they still had the same low death rate from the cancer as the radiation and surgery groups—about one percent. And the remaining portion that didn’t progress and go through treatments were able to dodge needless side effects.