Delaying treatment for localised prostate cancer does not increase mortality risk, trial shows

Press release issued: 13 March 2023

Active monitoring of prostate cancer has the same high survival rates after 15 years as radiotherapy or surgery, reports the largest study of its kind today. The latest findings from the ProtecT trial, led by the Universities of Oxford and Bristol, are presented today at the European Association of Urology (EAU) Congress in Milan and published in the New England Journal of Medicine.

The trial was funded by the National Institute for Health and Care Research (NIHR).

Although men on active monitoring – which involves regular tests to check on the cancer – were more likely to see it progress or spread than those receiving radiotherapy or surgery, this didn’t reduce their likelihood of survival. The trial also found that the negative impacts of radiotherapy and surgery on urinary and sexual function persist much longer than previously thought – for up to 12 years.

The findings show that treatment decisions following diagnosis for low and intermediate risk localised prostate cancer do not need to be rushed.

The trial was conducted in nine UK centres and is the longest running study of its kind. It is the first to fully evaluate three major treatment options: active monitoring, surgery (radical prostatectomy) and radiotherapy with hormones for men with localised prostate cancer.

Papers:

15-year outcomes after monitoring, surgery, or radiotherapy for localized prostate cancer by Freddie Hamdy et al. in the New England Journal of Medicine.
Patient-reported outcomes 12 years after treatment for localized prostate cancer by Jenny Donovan et al. in the New England Journal of Medicine.

Read the full University of Bristol press item