Men with low-risk prostate cancer can adopt a ‘watch and wait’ approach

Thousands of men with low-risk prostate cancer should be offered a “watch and wait” approach alongside other treatments, NHS officials say.

In updated guidance, the National Institute for Health and Care Excellence (Nice) said men should be offered a choice between active surveillance where the condition is monitored closely, radical prostatectomy (an operation to remove the prostate gland and surrounding tissues) or radical radiotherapy.

The guidance is for people with low-risk localised prostate cancer and doctors should discuss potential benefits and harms, Nice said.

It said evidence shows there is no difference between the three approaches when it comes to 10-year survival rates.

Both prostatectomy and radiotherapy have been shown to reduce disease progression compared with active surveillance, and they both cut down the chances the disease will spread to other parts of the body.

But people undergoing active surveillance have better urinary function than those offered the other treatments. Radiotherapy and prostatectomy are also linked to erectile dysfunction.

The move was welcomed by Prostate Cancer UK.

Data suggests around 7,800 men a year are diagnosed with low-risk, localised prostate cancer.

Heather Blake, director of support and influencing at Prostate Cancer UK, said: “It’s great news that the Nice guidelines now reflect the latest evidence and recommend that active surveillance should be offered as a primary option for men with low risk localised prostate cancer.

“This could potentially provide thousands of men with the opportunity to safely delay or avoid radical treatment and its associated side effects.

“What is crucial now is that active surveillance is consistently delivered to a high standard across the UK alongside the personalised information and support men need to confidently choose this approach and benefit from it for as long as possible.

“From our discussions with men we have discovered that the language used and information provided by clinicians about their individual cancer risk has a huge impact on their treatment decision.

“Regular, open communication with a trusted health professional and a personalised treatment plan are also crucial to ensuring men feel reassured and can maintain a good quality of life during their time on active surveillance.

“These factors must be addressed alongside the roll out of the Nice guidelines if men with low risk localised prostate cancer are to have the best outcomes.”