Active surveillance (AS) for patients with low-risk prostate cancer can provide similar quality of life to that of men living without cancer, according to a study presented at the European Association of Urology Congress (March 11-15; Munich, Germany).
With more than 400,000 cases each year, prostate cancer is the most common form of cancer in men. Patients are often treated with surgery or radiotherapy, but these approaches can lead to complications such as incontinence or erectile dysfunction that significantly impair quality of life. Instead, active surveillance—closely monitoring the cancer and only considering curative treatment if tumor conditions change— is increasingly being considered as an alternative approach to managing low-risk prostate cancer.
In a study led by Lionne Venderbos, MSc, LLB, PhD, Erasmus University Medical Center (Rotterdam, Netherlands), researchers compared active surveillance with immediate treatment of low-risk prostate cancer. Detailed questionnaires were sent to 427 patients (aged 66–69 years) with low-risk prostate cancer to track their quality of life during the 5–10 years after initial diagnosis.
In their responses on the questionnaires, patients who underwent active surveillance (n = 121) reported significantly higher quality of life scores than those who received surgery (n = 74), as well as better urinary function, less urinary incontinence, and better sexual function. These patients also reported significantly higher sexual satisfaction scores than those who received radiotherapy (n = 232). In fact, researchers found that the quality of life for patients undergoing active surveillance was similar to that of men without prostate cancer.
Researchers concluded that men on active surveillance experienced better prostate-related health and quality of life than men who received immediate treatment.
In a press release, Dr Venderbos advised, "When considering active surveillance, [patients] should try to imagine whether living with untreated cancer would cause any stress, or that the follow-up visits lead to stress instead of reassurance. Balancing the advantages and disadvantages per type of treatment will make that a man chooses that type of treatment that fits his wishes and preferences best.”