Active Surveillance For Prostate Cancer

Prostate cancers can vary from one another. Certain types proliferate rapidly and require immediate intervention, while others develop at a slower pace and have a reduced likelihood of metastasizing to other areas of the body. This latter category is classified as low risk.

In cases of slowly progressing prostate cancer, your healthcare provider may suggest a strategy of active surveillance.

What Is Active Surveillance and What Does it Do?

Active surveillance is a method of monitoring localized (early-stage) prostate cancer instead of initiating immediate treatment. This approach may also be referred to as active monitoring.

When you opt for active surveillance, you will undergo regular tests to assess the status of the cancer. The primary objective is to prevent unnecessary treatment unless these evaluations indicate that the cancer may be progressing, or you choose to pursue treatment thereby minimizing or postponing the potential side effects associated with treatment. Should there be indications of cancer growth, you will be presented with treatment options aimed at curing the disease.

Although it may seem unusual to forgo treatment, localized prostate cancer typically exhibits slow growth if any, and often carries a low risk of metastasis. Consequently, it may not lead to any complications or impact your lifespan. A significant number of men under active surveillance will never require treatment.

It is important to note that active surveillance differs from watchful waiting, which represents an alternative approach to monitoring prostate cancer.

Top Candidate For Active Surveillance

You may qualify for active surveillance if you satisfy the following criteria:

• Cancer is limited to the prostate.
• The tumor is small and anticipated to grow at a slow rate.
• Not experiencing any symptoms.
• Capable of managing your cancer without significant concern that would diminish your quality of life.
• Prioritize the immediate quality of life over any potential long-term repercussions that may arise.
• Possess a relatively extended life expectancy and could benefit from curative local therapy should your cancer advance.

Men diagnosed with localized prostate cancer that is classified as intermediate risk or higher, and who have a life expectancy exceeding a limited duration, typically require local treatment and are generally not suitable candidates for active surveillance.

In considering active surveillance, each patient must thoughtfully evaluate the potential decline in quality of life associated with treatment against the risk that the opportunity for a cure may be lost without intervention.

What Does Prostate Cancer Active Surveillance Involve?

During the course of active surveillance, you will undergo tests every few months to detect any alterations in your prostate. Additionally, you will have consistent follow-up appointments with your active surveillance advanced practice provider (APP). When deemed suitable, genetic or genomic testing may be recommended. The results from these assessments will be utilized by your care team to keep track of the cancer’s progression.

Active surveillance monitoring consists of four components:

1. A prostate biopsy  
2. Prostate magnetic resonance imaging (MRI)  
3. Prostate-specific antigen (PSA) blood testing  
4. A digital rectal exam (DRE)  

Advantages And Disadvantages of Active Surveillance For Prostate Cancer

Determining whether to pursue active surveillance is a personal decision. What holds significance for one individual may not resonate with another. If you are presented with the option of active surveillance, it is advisable to consult with your doctor or nurse prior to making a decision; they can assist you in evaluating whether this approach is suitable for your situation. Utilizing our list of questions to engage with your healthcare provider may also prove beneficial.

Advantages  

• By opting for active surveillance, you will not undergo treatment, thereby avoiding the associated side effects.  
• This approach is less likely to disrupt your daily life compared to more invasive treatments.  
• Should tests indicate potential growth of your cancer, there are available treatment options aimed at achieving a cure.

Disadvantages  

• You may be required to undergo additional prostate biopsies, which can lead to side effects and may be uncomfortable or painful for some men.  
• Changes in your overall health could render certain treatments inappropriate if they become necessary.  
• Some individuals may experience anxiety regarding the absence of treatment and the possibility of cancer progression; however, it is possible to reconsider and initiate treatment if this becomes a concern.  
• There is a slight risk that your cancer may progress more rapidly than anticipated, complicating treatment options, although this occurrence is quite rare.

Also Read:- Prostate Cancer Treatment Cost in India

When Would I Need To Stop Active Surveillance?

Should the test results indicate that your cancer is progressing or has become more aggressive, you will be presented with treatment options designed to eliminate the cancer, such as surgery or radiotherapy.

You have the autonomy to choose to undergo treatment at any point, regardless of the duration of your active surveillance. Managing life with cancer without treatment can be challenging, often leading to feelings of stress, worry, and anxiety. Some individuals may opt for treatment even in the absence of any noticeable changes. If you choose to pursue treatment, it is advisable to consult with your doctor or nurse.

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