Active Surveillance

Because many, if not most, prostate cancers are slow growing and will never cause a problem, Active Surveillance is a treatment option for men with low grade disease, men in their 70s or have serious medical problems. Given the side effects of active treatment (surgery, radiation, etc.), this option is considered appropriate for men with very low or low-grade cancers.

We know it’s difficult to consider this more passive approach, but more and more men are becoming comfortable with this choice.

If you choose Active Surveillance, it is even more important for you to eat whole fruits, vegetables and grains; cut way back on dairy products, alcohol and grilled meats; quit tobacco and get some exercise. According to Johns Hopkins, diet and lifestyle have a significant influence on prostate cancer.

The Active Surveillance protocol is a:

• PSA every 3 to 6 months
• DRE every 6 to 12 months
• Needle biopsy in 6 months if less than 10 cores were taken in the first biopsy
• Repeat biopsy within 18 months and anytime thereafter if the PSA or DRE become suspicious.

 Advantages are:

• Avoids treatment if the cancer is not aggressive
• Avoids side effects of treatment

Disadvantages are:

• Chance of missed opportunity of cure
• Risk of cancer spreading
• Treatment and side effects may be more complicated
• Anxiety of knowing you have cancer
• Need for frequent doctor visits and procedures
• Identifying aggressive vs. indolent (non-aggressive) cancers