{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T22:16:19Z","timestamp":1791238579460,"version":"4.1.0"},"reference-count":61,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2025,10,6]],"date-time":"2025-10-06T00:00:00Z","timestamp":1759708800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["bjui-journals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJU International"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To examine contemporary evidence supporting non\u2010surgical interventions for patients with early prostate cancer (PCa) on active surveillance (AS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A literature search was conducted using the databases PubMed, Medline, and Embase in January 2024 to identify relevant articles published from 2011 onwards. Randomised controlled trials (RCTs) and cohort studies reporting on interventions in patients with PCa on AS were included.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Several studies have investigated a range of non\u2010surgical interventions, from exercise and food supplements to androgen receptor pathway inhibitors (ARPIs). The largest RCTs of ARPIs have shown the greatest effect in delaying disease progression to aggressive PCa, however, concerns exist around toxicity, long\u2010term oncological safety, and mortality benefit. Nutraceuticals, dietary modifications, and exercise appear to be well tolerated, but evidence of oncological benefit from large\u2010scale RCTs is lacking. A major challenge is the lack of consensus on criteria for entry to and exit from AS as pre\u2010biopsy magnetic resonance imaging reduces diagnosis of the lowest\u2010risk disease. Molecular and imaging biomarkers may help refine baseline risk stratification and guide monitoring during surveillance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Current evidence supporting interventions for patients on AS remains largely based on small prospective cohort studies or open\u2010label phase II trials. There is growing interest in short\u2010term ARPIs for patients at higher risk of disease progression, while nutraceuticals, diet and exercise may have a role for long\u2010term use in lower\u2010risk patients. Large, well\u2010powered RCTs with long\u2010term outcomes testing different interventions and incorporating molecular and imaging biomarkers are warranted.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/bju.70005","type":"journal-article","created":{"date-parts":[[2025,10,6]],"date-time":"2025-10-06T23:37:45Z","timestamp":1759793865000},"page":"990-1001","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Interventions for patients with prostate cancer on active surveillance: a narrative review"],"prefix":"10.1111","volume":"136","author":[{"given":"Simran","family":"Gill","sequence":"first","affiliation":[{"name":"Centre for Cancer Cell and Molecular Biology, Barts Cancer Institute Queen Mary University of London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Runzhi","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Urology Royal Surrey County Hospital NHS Foundation Trust  Guildford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2220-893X","authenticated-orcid":false,"given":"Benjamin W.","family":"Lamb","sequence":"additional","affiliation":[{"name":"Centre for Cancer Cell and Molecular Biology, Barts Cancer Institute Queen Mary University of London  London UK"},{"name":"Department of Urology Barts Health NHS Trust  London UK"},{"name":"Department of Urology University College London Hospitals NHS Foundation Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0202-7912","authenticated-orcid":false,"given":"Caroline M.","family":"Moore","sequence":"additional","affiliation":[{"name":"Department of Urology University College London Hospitals NHS Foundation Trust  London UK"},{"name":"Division of Surgery and Interventional Science University College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2787-8828","authenticated-orcid":false,"given":"James W.F.","family":"Catto","sequence":"additional","affiliation":[{"name":"Division of Clinical Medicine, School of Medicine and Population Health University of Sheffield  Sheffield UK"},{"name":"Department of Urology Sheffield Teaching Hospitals NHS Foundation Trust  Sheffield UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jack","family":"Cuzick","sequence":"additional","affiliation":[{"name":"Centre for Cancer Screening, Prevention, and Early Diagnosis, Wolfson Institute of Population Health Queen Mary University of London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter D.","family":"Sasieni","sequence":"additional","affiliation":[{"name":"Centre for Cancer Screening, Prevention, and Early Diagnosis, Wolfson Institute of Population Health Queen Mary University of London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8064-9878","authenticated-orcid":false,"given":"Prabhakar","family":"Rajan","sequence":"additional","affiliation":[{"name":"Centre for Cancer Cell and Molecular Biology, Barts Cancer Institute Queen Mary University of London  London UK"},{"name":"Department of Urology Barts Health NHS Trust  London UK"},{"name":"Department of Urology University College London Hospitals NHS Foundation Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,10,6]]},"reference":[{"key":"e_1_2_10_2_1","unstructured":"Cancer Research UK.Cancer incidence statistics. 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