Active Surveillance for Prostate Cancer

There are many treatment options for prostate cancer, and sometimes the best option is “active surveillance.” Active surveillance is not lack of treatment but a strategy to treat you only if and when such treatments are warranted.

Several studies on active surveillance have been conducted at John Hopkins Medical Center and the most recent one found that this program did not increase the risk of death from prostate cancer, but it did allow the participants to avoid or delay the side effects that occur from aggressive treatment. While active surveillance is not appropriate for every man with prostate cancer, it may be appropriate for those with very non-aggressive, low-risk form of this disease.

Active Surveillance

When receiving a cancer diagnosis, most people ask about their treatment options and some prostate cancer patients are surprised to learn that active surveillance is a better choice. The goal of this program is to allow men with low-risk prostate cancer to avoid or delay radical treatments and their associated risks and side effects, including urinary dysfunction and erectile dysfunction.

A successful active surveillance process requires:

• Vigilant monitoring.
• Compliant patient with the testing schedule and follows their physician’s recommendations.
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As with many treatment processes, the optimal outcomes are achieved with the physician and patient work together toward the goals of management and recovery.

Best Candidates for Active Surveillance

According to the American Society of Clinical Oncology, patients with low-risk, low-grade disease, meaning that they have a Gleason score of 6, can consider active surveillance. Other considerations may include:

• The cancer is confined to the prostate, meaning that it hasn’t spread to other organs or systems;
• The tumor is small and is expected to grow slowly;
• You are not experiencing any symptoms;
• You are able to live with cancer without the worry of your condition reducing your quality of life;
• You value your near-term quality of life to a greater extent than any long-term consequences that could occur; and
• You have a relatively long life expectancy and may benefit from a curative local therapy if your cancer progresses.
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Men who have other significant health issues, such as heart disease or diabetes, may also choose an active surveillance program to monitor their prostate cancer while seeking care for these other conditions.

Active Surveillance Testing Schedule

The American Society of Clinical Oncology recommends the following evaluations for patients under active surveillance for prostate cancer:

• PSA testing every three to six months
• A digital rectal exam (DRE) at least once a year
• A prostate biopsy at least every two to five years (after the follow-up biopsy within six to 12 months of diagnosis)

If test results or symptoms indicate the cancer is progressing, treatment is recommended with the intention of curing the disease.

It is important to note that other medical experts offer different recommendations regarding the frequency of testing and when treatment should begin. Ultimately, your urologist will make recommendations based on your specific situation.

At Kasraeian Urology, we offer a full range of treatment options for men with prostate cancer, including active surveillance. If you require a prostate cancer screening or have been diagnosed with this disease, we provide the support and care needed to achieve the best possible outcome. Contact us today to schedule your appointment with our prostate cancer experts.