New research indicates that active monitoring is as effective as aggressive treatment for early-localized prostate cancer patients.

The randomized study followed men who had been diagnosed with the disease and found that “at a median of 10 years, prostate cancer–specific mortality was low irrespective of the treatment assigned, with no significant difference among treatments,” said lead author Dr. Freddie C. Hamdy and fellow researchers in their JAMA report on the National Institute for Health Research–supported Prostate Testing for Cancer and Treatment (ProtecT) trial in the U.K.

Death rates hovered near just one percent for all.

“There’s been no hard evidence that treating early disease makes a difference,” Hamdy, of the University of Oxford, stated, according to CBS News.

The findings are striking. “Virtually no one had died from prostate cancer,” Dr. Mark Litwin, chair of urology at the David Geffen School of Medicine at UCLA, told Scientific American. Litwin was not part of the research. “All three groups have almost 100 percent surviving. That should give all men pause before pursuing radical treatment for low- or intermediate-risk tumors.”

The pause, however, is not without clinical impact. The study did find that cancer spread twice as frequently in those not receiving treatment.

“I can counsel patients better now,” Hamdy told the New York Times. “I can tell them very precisely, ‘Look, your risk of dying from cancer is very, very small. If you receive treatment you will get some benefit. It will reduce the disease from growing outside your prostate, but these are exactly the side effects you might expect.’”

The study looked at a total of 82,429 men who had a PSA test, of which 2,664 were diagnosed with localized prostate cancer. Of these, 1,643 volunteered to be followed in the randomized trial, and to receive active monitoring, radical prostatectomy or radiotherapy.

“This is the first time that radiotherapy, surgery, and active monitoring for prostate cancer have been directly compared in a large randomized trial, with a 10-year follow-up,” Hamdy said, according to The New York Daily News.

The American Society for Radiation Oncology (ASTRO) “congratulated” the study authors, noting that the paper stressed the vital importance of patients and doctors making a “joint decision” about early stage disease.

“These findings underscore the essential role of dialogue in treatment selection,” said ASTRO President Dr. David C. Beyer, who stressed in a statement that “men with prostate cancer are all different, and the relative costs and benefits associated with the multiple options to treat it can vary substantially between individuals.

"The best treatment decisions for prostate cancer, or any cancer, take into consideration the specifics of each individual patient’s disease, expectations and preferences," Beyer continued. "These options can be confusing, and patients should always make these decisions after consultation with a radiation oncologist and urologist.”

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