There is no difference in the survival rate for men with early prostate cancer who opt for treatment, such as surgery or radiation, and those who simply monitor their cancer, a new study found. In fact, the 10-year survival rate was so high—99%—that researchers are calling into question whether any treatment is needed for early stage prostate cancer, the AP reports, or even whether early screening is worthwhile. "There's been no hard evidence that treating early disease makes a difference," Dr. Freddie Hamdy, lead author of the study in the New England Journal of Medicine. PSA (prostate specific antigen) blood tests have already been criticized by doctors who warn they have led to over-treatment of early prostate cancer with debilitating side effects such as sexual dysfunction and urinary problems, reports Time. In Europe, PSA testing is far less common, notes the AP. High levels can indicate cancer but also a natural prostate enlargement that comes with age.
Prostate cancer is one of the slowest-moving cancers, yet Hamdy noted that men often choose aggressive treatment at the outset because it is not known which cases will develop rapidly. “I hope this helps patients to be better informed and to not rush into treatment decisions,” Hamdy said, per Time. The study looked at more than 82,000 British men, aged 50 to 69. Of those whose PSA test showed they were in the early stages, 1,643 agreed to be assigned surgery, radiation, or active monitoring every three to six months. Although more men in the monitoring group saw their cancers worsen after 10 years, those assigned treatment experienced unpleasant side effects. Death rates among all the men were equal. But Dr. Otis Brawley, chief medical officer for the American Cancer Society, said it will be difficult to convince men to choose monitoring. "Our aggressive approach to screening and treating has resulted in more than 1 million American men getting needless treatment," he told the AP. (Smoking and cancer is a deadly combination.)