Active Surveillance of Prostate Cancer

Posted on: August 11th, 2016

NYT Active Surveillance man w car

Prostate Cancer: Active Surveillance or Active Treatment?

If you were diagnosed with prostate cancer, what would you do after the news settled in?  Would you seek immediate treatment?  What treatment options would you explore?  According to an article recently published in the New York Times, men are more likely than ever to hold off on active treatment if their prostate cancer is detected at an early stage.  Reportedly, the number of men choosing “active surveillance” has quadrupled in the past five years.  Therefore, Chicago Prostate Cancer Center reminds men who choose active surveillance to work closely with their physician to understand how to best monitor prostate cancer for signs of progression, and determine whether and when to actively treat it.  (In a recent, related blog we share concerns that a reduction in prostate cancer screening may impact the number of cases of more aggressive cancer.)

What is Active Surveillance?

Active Surveillance (also known as “expectant management”, or “watchful waiting”) for men with prostate cancer is the postponement of immediate therapy (such as brachytherapy, external beam radiation or surgery) if there is no evidence that the patient is at increased risk for disease progression.   Active surveillance is an accepted option for the initial management of carefully selected men whose cancer cells occur within—not outside—the prostate gland, appearing almost normal under the microscope.  These men may have less risk of fast cancer cell growth and may safely choose to undergo a planned evaluation schedule including PSA tests, digital rectal examinations (DRE), and prostate biopsies.

When, or do, I switch to Active Treatment?

If there is evidence that the cancer is growing, treatment can be recommended at that time, with the intention of curing the disease.  With timely monitoring, patients can be reclassified as higher risk for disease progression and then undergo a specific therapy without substantially decreasing the chance of cure.  Read more about prostate cancer treatment options.

Is Active Surveillance right for me?

 Treating over 15,000 men with prostate cancer, Chicago Prostate Cancer Center (CPCC) created a specific set of recommendations to guide men deciding whether Active Surveillance is their best care strategy, at least for their initial approach.   Click and scroll to CPCC’s  Active Surveillance Guidelines which include a profile of Who is the Best Candidate for Active Surveillance.

While it is important to work with your doctor to discuss these guidelines in the context of your own specific health situation, it is also important to check your feelings:  patients need to be of the correct mindset for this option, as knowledge of having a cancer, but not treating it, can cause anxiety.  We work hand in hand with Prostate Cancer Foundation of Chicago, which hosts a Patient Support Group that helps men cope with prostate cancer concerns such as Active Surveillance.

Finding “hidden tumors”

Finally, CPCC Active Surveillance Guidelines recommend a specific type of prostate biopsy for the most comprehensive results possible.  Watch for our upcoming blog to discover how biopsy advancements by Chicago Prostate Cancer Center are of special benefit to men choosing Active Surveillance.