Active Surveillance
Active surveillance for prostate cancer involves closely monitoring the patient for changes in tumor growth. This will require continuing PSA blood tests and periodic MRI and prostate biopsies.
Reasons for Active Surveillance
Patients may choose active surveillance to avoid the side effects of treatment if their risk of prostate cancer growth is lower.
Because some prostate cancers grow very slowly, some of these cancers may be surveilled.
Active surveillance for prostate cancer may be an option if:
The cancer is small and localized. This will usually mean that on a 12 core biopsy that three or fewer cores are involved. In addition, any single core should show less than 50% involvement.
The patient’s Gleason score is low. Patients with a low Gleason score (usually six or lower) have a slower growing form of cancer that may be monitored closely.
The patient has other serious health problems. Patients with other serious health conditions, such as severe heart disease, have a shortened life expectancy and therefore some prostate cancer may not cause harm in their expected lifetime.
Risks of Active Surveillance for Prostate Cancer
Patients who choose active surveillance do face risks that should be weighed before making a decision.
Anxiety: Patients may feel anxious and have a sense of uncertainty about the status of their cancer.
Frequent medical appointments: Choosing active surveillance requires close follow up with PSA blood test, MRIs and biopsy and doctor’s appointments every few months.
Cancer growth: During active surveillance, prostate cancer growth will of course continue. Close follow up is necessary to catch any changes so that definitive treatment can be performed before spread might occur.
