Management of nonmetastatic prostate cancer with watchful waiting

The purpose of watchful waiting in prostate cancer is to avoid adverse effects of active treatment in men who are unlikely to experience long-term benefits of radical treatments due to their limited life expectancy.

Is watchful waiting an appropriate management strategy for men with nonmetastatic prostate cancer and a life expectancy of less than 10 years?

This original investigation followed more than 5000 men who were registered in the National Prostate Cancer Register of Sweden diagnosed since 2007 with follow-up extending to more than 20 years. After 5 years, 66.2% of the men with low-risk prostate cancer and 36.1% of the men with high-risk prostate cancer were still alive and not requiring hormonal therapy. At 10 years, 25.5% (low-risk prostate cancer) and 10.4% (high-risk prostate cancer) were still alive and not receiving hormonal therapy. After 10 years, 4.1% of the men with low-risk prostate cancer and 10.8% of the men with high-risk prostate cancer had transitioned to hormone-therapy- resistant prostate cancer (CRPC). Ten years after diagnosis 92.3% of the deaths in the low-risk group and 84.1% of the deaths in the high-risk group were from causes other than prostate cancer.