Active Surveillance – One of Several Options for Prostate Cancer

When a patient is diagnosed with prostate cancer, understanding and considering a course of treatment can be overwhelming. As you and your physician consider which treatment may be best for you, it is important to understand how far your cancer has progressed, potential treatment-related side effects and your general health.

One treatment option that we always consider at The Urology Group is no treatment at all. This is commonly referred to as “active surveillance” and may be right for some patients.

The “active surveillance” approach monitors the cancer over time to assess progression rather than intervening immediately with surgery, radiation therapy or other treatments.

Typically, active surveillance can be an option when the prostate cancer is:

• not causing any symptoms
• expected to grow slowly
• small and contained within the prostate

This “wait and see” approach requires regularly scheduled prostate specific antigen (PSA) tests and digital rectal exams (DRE), as well as a repeat biopsy of the prostate at one year, and specific intervals thereafter.

At any time, if symptoms develop or progression of the cancer is detected, treatment may be warranted.

The profile of a candidate for active surveillance includes a low grade (Gleason 6 or under), low-risk prostate cancer (low PSA and stage) that appears to be low in volume (small amount of cancer found on biopsy, for example). Lifestyle considerations may also be a factor. Researchers are currently developing biomarkers and additional tests to make this decision easier and more accurately informed.

Active surveillance might also be a good choice for older men with limited life expectancy. In addition, if a man is currently battling other serious disorders or diseases, such as heart disease, long-standing high blood pressure, or poorly controlled diabetes, it may be best to hold off on therapy and avoid its potential complications.

Any decision regarding prostate cancer treatment needs to be fully informed and have the support of the patient’s loved ones as well as the physician and healthcare team.