Men with localized prostate cancer needn’t rush to get treated.

Researchers followed 1,643 men who had been randomly assigned to surgery, radiation, or active surveillance between 1999 and 2009 and had annual evaluations to look for a rise in PSA scores or other evidence that the cancer had spread.

After 15 years, only 45 men (about 3 percent) had died of prostate cancer, with no difference between groups. Metastases were found in 51 men—and long-term androgen-deprivation therapy (ADT) was necessary in 69 men—in the active surveillance group, roughly twice as many as in the radiation group or surgery group. ADT suppresses testosterone levels, causing problems like erectile dysfunction and reduced sexual desire.

What to do

If you’ve been diagnosed with low-risk prostate cancer, consider active surveillance, as the American Urological Association recommends.