In a study involving 1,298 men diagnosed with prostate cancer, just two died from the disease and three developed metastatic disease over 20 years of 'active surveillance', where they were regularly checked by a urologist but had no treatment.
When the study began in 1995, the men had annual biopsies until they reached the age of 75 so that the aggressiveness of the tumour could be assessed. Today, biopsies have been dropped in favour of less-invasive MRI scans.
Researchers from the Brady Urological Unit at Johns Hopkins reported that 47 men in the group died from another cause, most commonly heart disease. They estimate that a man diagnosed with prostate cancer is 24 times more likely to die from another disease.
"The natural progression of prostate cancer occurs over a long period of time, some 20 years, and most men with low-risk prostate cancer will die of another cause, "said lead researcher H Ballentine Carter.
The other advantage of active surveillance is that it doesn't come with the side effects of a more aggressive approach. In another study, 20 per cent of men who had radiation or surgery for their prostate cancer were readmitted to hospital within five years because of a complication.
(Source: Journal of Clinical Oncology, 2015; August 2015; doi: 10.1200/JCO.2015.62.5764)