Prostate Cancer Treatment Offers Long-Term Survival

Guideline Adherence Significantly Lowers Mortality Risk

New research indicates that adhering to recommended treatment protocols for nonmetastatic prostate cancer leads to encouraging long-term survival outcomes, offering significant reassurance to patients.

Study Highlights Treatment Effectiveness

A comprehensive study analyzing data from over 135,000 Swedish patients with nonmetastatic prostate cancer has revealed compelling evidence of improved survival rates when NCCN guideline-recommended treatments are utilized. The research, published in the Journal of the National Comprehensive Cancer Network, found that adherence to these guidelines is associated with a substantially lower risk of prostate cancer mortality.

For individuals diagnosed with low- to intermediate-risk prostate cancer, the likelihood of dying from the disease was found to be six times less than the risk of mortality from other health issues. Even for those with high-risk prostate cancer, the study demonstrated that the risk of death from other causes remained twice as high as the risk of dying from prostate cancer itself.

“Our data support adherence to guideline recommendations for treatment of prostate cancer,” said lead author Pietro Scilipoti, MD, of Uppsala University in Sweden and IRCCS San Raffaele Hospital in Italy. “If guideline-recommended treatment is used, most people with prostate cancer will live for many years after diagnosis. That includes active surveillance as an excellent treatment strategy for appropriately selected people.”

The study examined a large cohort of patients with a life expectancy exceeding three years. Among these individuals, nearly half received treatments aligned with NCCN guidelines. Treatment modalities included radical prostatectomy, radiotherapy (with or without androgen deprivation therapy), and active surveillance, reflecting a spectrum of evidence-based approaches.

Mortality Rates Vary by Risk and Life Expectancy

Analysis of the data provided specific mortality figures. For patients with low-risk disease, the 15-year mortality rate from prostate cancer was 5.5%, a stark contrast to the 37% mortality from other causes. Similarly, even among those with very high-risk prostate cancer, the 15-year mortality rate from the cancer was 22%, while mortality from other causes stood at 36%.

Long-term projections were also encouraging. The estimated 30-year mortality risk from prostate cancer for low-risk patients was approximately 12%, with a significantly higher risk of 77% from other causes. For high-risk patients, the 30-year prostate cancer mortality was around 20%, compared to 67% from other causes. These figures were further refined by considering patients’ life expectancy, highlighting that those with a longer life expectancy generally experienced lower cancer-specific mortality.

For instance, in the low-risk group with a life expectancy over 15 years, the 15-year prostate cancer mortality was as low as 2.5%, with other causes accounting for 20% mortality. This underscores the importance of personalized care and considering individual health profiles when managing prostate cancer.

“This study offers a big sigh of relief for many men facing a prostate cancer diagnosis,” concluded Ahmad Shabsigh, MD, of The Ohio State University Comprehensive Cancer Center – James Cancer Hospital and Solove Research Institute, Member of the NCCN Guidelines Panel for Prostate Cancer. “It reveals that with NCCN Guidelines-recommended treatment, you’re significantly more likely to die from something else—up to 6 times more likely, in fact—even if your cancer is high-risk. This holds true even when looking at data from a different health care system, like Sweden’s. What’s truly striking is that for patients with low-risk prostate cancer, many of whom were on active surveillance, the 30-year mortality risk from the cancer itself was only about 11%. It really underscores the power of evidence-based treatment plans and the importance of focusing on a person’s overall health, not just their cancer.”

This robust evidence supports the efficacy of current clinical guidelines in managing prostate cancer, emphasizing that proactive and evidence-based treatment significantly improves long-term patient outcomes. According to the American Cancer Society, prostate cancer is the second most common cancer diagnosed in men in the United States, with over 290,000 new cases expected in 2024 (American Cancer Society, 2024).