• Posted May 15, 2025

Improvements In Prostate Cancer Tracking Help Men Stay In Active Surveillance

THURSDAY, May 15, 2025 (HealthDay News) — Men in “watchful waiting” mode for their low-risk prostate cancer are staying healthier longer thanks to advanced imaging and treatments designed to keep their tumor at bay, a new study says.

Advanced MRI imaging and MRI-guided biopsies are providing a much clearer view of the prostate, allowing doctors to more easily track cancer changes over time, researchers wrote in The Journal of Urology.

Meanwhile, focal therapies are curbing the progress of prostate cancer by using heat, cold and electricity to kill tumor cells on the prostate, researchers said.

This combination is allowing men to remain in active surveillance longer without surgery or radiation therapy, which can cause long-lasting side effects like impotence and incontinence, researchers said.

“This represents a major advancement in the management of prostate cancer,” senior researcher Dr. Leonard Marks, chair of urology at the David Geffen School of Medicine at UCLA, said in a news release.

“By combining MRI-guided diagnosis with selective focal therapy, we can offer men a more personalized approach,” Marks said. “This strategy not only helps avoid unnecessary procedures, but also gives us a better way to predict who will benefit from extended surveillance, potentially improving quality of life and reducing side effects without compromising safety.”

About 60% of men with low-risk prostate cancer are in active surveillance, where doctors hold off on treatment until there are signs the tumor has progressed, according to the National Cancer Institute.

These low-risk prostate cancers grow so slowly that they may never cause symptoms, and men with these tumors are more likely to die from some other cause, experts say.

However, many men are queasy with the thought of having an untreated cancer, and they wind up opting for surgery or radiation even though the chances of unpleasant and lasting side effects are high, researchers said.

To improve men’s confidence in active surveillance, researchers tested whether using MRI-guided biopsy and focal therapy could make watchful waiting safer, more effective and easier for patients to stay on longer.

For the study, researchers analyzed data from 869 men in UCLA’s active surveillance program between 2010 and 2022. All patients had an MRI-guided biopsy at the start that showed low- to medium-risk prostate cancer.

Starting in 2016, some of the men also were offered focal therapy if their cancer was slightly higher-risk or had showed signs of progressing. 

About a quarter of the men wound up undergoing focal therapy, which uses cold gases, lasers, ultrasound or electric shocks to kill off cancer cells.

MRI was highly accurate in identifying cancers that qualified for active surveillance, correctly predicting stable tumors in 90% to 95% of men with low-risk cancer and 70% of men with medium-risk cancer, results show.

In fact, the MRI was so accurate that there was a reduced need for repeat biopsies, researchers said.

Results also showed a decline in men leaving active surveillance due to anxiety, which could reflect growing confidence in MRI-based monitoring, researchers said.

“Although the numbers for the focal therapy group are small and the follow up was relatively brief, the near-term advantage of focal therapy in avoiding surgery or radiation is clear,” Marks said.

“This study offers some of the strongest evidence yet that active surveillance, when guided by modern imaging and minimally invasive treatments like focal therapy, can safely be expanded to more patients,” he concluded.

However, researchers said these techniques should be further tested in larger studies involving more hospitals.

More information

The Cleveland Clinic has more on focal therapy for prostate cancer.

SOURCE: UCLA, news release, May 8, 2025