Largest UK trial of treatment for prostate cancer publishes first results

Active monitoring is as effective as surgery and radiotherapy, in terms of survival at 10 years, reports the largest study of its kind, funded by the National Institute for Health Research (NIHR). Results published in New England Journal of Medicine today show that all three treatments result in similar, and very low, rates of death from prostate cancer. Surgery and radiotherapy reduce the risk of cancer progression over time compared with active monitoring, but cause more unpleasant side-effects. The ProtecT trial, led by researchers at the Universities of Oxford and Bristol in nine UK centres, is the first trial to evaluate the effectiveness, cost-effectiveness and acceptability of three major treatment options: active monitoring, surgery (radical prostatectomy) and radiotherapy for men with localised prostate cancer. Chief investigator Professor Freddie Hamdy, from the University of Oxford, said: "What we have learnt from this study so far is that prostate cancer detected by PSA blood test grows very slowly, and very few men die of it when followed up over a period of 10 years - around one per cent - irrespective of the treatment assigned. This is considerably lower than anticipated when we started the study. "However, treating the disease radically when found reduces the number of men who develop spread of prostate cancer, but we do not know yet whether this will make a difference to them living longer or better, and we have been unable to determine reliably which disease is lethal, and which can be left alone." Between 1999 and 2009, 82,429 men aged 50 to 69 across the UK, who were tested and 1,643 diagnosed with localised prostate cancer, agreed to be randomised to active monitoring (545), radical prostatectomy (553) or radical radiotherapy (545).