Men who 'monitor' their prostate cancers have high quality of life

(Reuters Health) - Men who decide with their doctors to keep a close eye on their prostate cancer - instead of treating it right away - tend to have physical and mental wellbeing equal to or better than men who opt for immediate treatment, suggests a new analysis.

Additionally, the men who decided to track their cancers in a process known as "active surveillance" did not appear to suffer added emotional stress, researchers found.

"The men in our study did not appear to suffer from any major negative psychological impacts, including anxiety and depression," said Dr. Lara Bellardita, the study's lead author from the IRCCS Foundation's National Cancer Institute in Milan, Italy.

Prostate cancer usually grows very slowly. Men often opt for active surveillance to avoid or delay the side effects that can come with treatment, such as erectile dysfunction, urinary incontinence, and gastrointestinal problems, said Bellardita.

"These slow growing tumors do not necessarily need aggressive local treatment and can be safely followed with active surveillance," said Dr. Marc A. Dall'Era, whowasn't involved with the new study but is a urologist at the University of California, Davis.

Many men with prostate cancer will never need treatment for it, while about a third will go on to get treated after an average of two to three years of surveillance, he said.

While the side effects of prostate cancer treatments may affect quality of life, questions remain over how men fare while on active surveillance, the researchers write in the journal European Urology.

For example, they say, some people question whether living with untreated cancer could make men more anxious.

Bellardita and her colleagues reviewed previous studies and found 10 reports published between 2006 and 2014 that looked at quality of life and other psychological issues that men with prostate cancer might experience.

The 10 studies included 966 men with prostate cancer who had been followed for up to three years. The average age was 66. All of the men had chosen active surveillance over treatment.

Overall, the quality of life scores of men who chose active surveillance was similar to men who had their prostate removed. Anxiety, depression and general distress scores also didn't appear worse for the men who chose active surveillance.

Published reports as well as reports from physician practices suggest that men who opt for active surveillance are likely to enjoy a satisfactory level of well being, said Bellardita.

She and her coauthors write that men who opt for active surveillance should still be assessed for these potential problems and offered support as needed, however.

SOURCE: European Urology, online October 31, 2014.