Ann Robinson’s research reviews—4 May 2023

Sitting tight with localised prostate cancerIn this landmark UK study, over 82 000 men aged 50-69 had a prostate specific antigen (PSA) test, and 3.2% were diagnosed with localised prostate cancer. Just over half of these were randomly allocated to active monitoring, prostatectomy, or radiotherapy. Despite the fact that a third of participants had intermediate or high risk disease at diagnosis, the old teaching that you’re more likely to die with prostate cancer than of it held true. Over the 15 year study period, 21.7% of participants died from any cause, with no significant difference between the three groups. There were small differences between those treated with active monitoring, prostatectomy, or radiotherapy (prostate cancer-specific mortality 3.1% v 2.2% v 2.9%, development of metastases 9.4% v 4.7% v 5%). There was less local progression and less need for long term androgen deprivation therapy in the actively treated groups. All treatments were…
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