Prostate Cancer Treatment (PDQ®)–Health Professional Version

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Changes to This Summary (01/06/2017)

The PDQ cancer information summaries are reviewed regularly and updated as new information becomes available. This section describes the latest changes made to this summary as of the date above.

Treatment Option Overview for Prostate Cancer

Revised text to state that in the aggregate, men managed by watchful waiting or active surveillance/active monitoring have had very favorable prostate–cancer-specific mortalities ranging from about 1% to 10%. Added that a majority of men with screen-detected prostate cancer may be candidates for active surveillance/active monitoring with definitive therapy reserved for signs of tumor progression; referenced the Prostate Testing for Cancer Treatment (ProtecT) randomized trial that compared active monitoring, radical prostatectomy, and radiation therapy (cited Hamdy et al. as reference 17).

Added text to include a summarization of the ProtecT trial of 82,429 men who were screened with prostate-specific antigen testing, 2,664 who were diagnosed with clinically localized prostate cancer, and 1,643 who consented to a randomly assigned comparison of active monitoring, radical prostatectomy, or external-beam 3-D conformal radiation therapy with a primary endpoint of prostate cancer-specific mortality; added statistics about the 10-year median follow-up that showed no statistically significant differences in the three arms (cited level of evidence 1iiA); added statistics to state the all-cause mortality was nearly identical in all three arms (cited level of evidence 1iiB); added that there were statistically significant differences in progression to metastatic disease among treatment arms; added that there were substantial differences in patient-reported outcomes among the three management approaches (cited Donovan et al. as reference 34 and level of evidence 1iiC) and included statistical data about urinary incontinence, sexual function, and bowel function.

Stage II Prostate Cancer Treatment

Added text to include a summarization of the ProtecT trial of 82,429 men who were screened with prostate-specific antigen testing, 2,664 who were diagnosed with clinically localized prostate cancer, and 1,643 who consented to a randomly assigned comparison of active monitoring, radical prostatectomy, or external-beam 3-D conformal radiation therapy with a primary endpoint of prostate cancer-specific mortality (cited Hamdy et al. as reference 19); added statistics about the 10-year median follow-up that showed no statistically significant differences in the three arms (cited level of evidence 1iiA); added that there were statistically significant differences in progression to metastatic disease among treatment arms; added statistics to state the all-cause mortality was nearly identical in all three arms (cited level of evidence 1iiB); added that there were substantial differences in patient-reported outcomes among the three management approaches (cited Donovan et al. as reference 20 and level of evidence 1iiC) and included statistical data about urinary incontinence, sexual function, and bowel function.

This summary is written and maintained by the PDQ Adult Treatment Editorial Board, which is editorially independent of NCI. The summary reflects an independent review of the literature and does not represent a policy statement of NCI or NIH. More information about summary policies and the role of the PDQ Editorial Boards in maintaining the PDQ summaries can be found on the About This PDQ Summary and PDQ® - NCI's Comprehensive Cancer Database pages.

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