Active surveillance of prostate cancer

A management strategy for prostate cancer

Active surveillance of prostate cancer is a management strategy for prostate cancer that involves closely monitoring the condition without immediate treatment. This approach is typically considered for men with low-risk, localized prostate cancer, where the disease is not causing any symptoms and is expected to progress slowly.

Overview

Active surveillance is an option for men with low-risk prostate cancer, which is characterized by a low Gleason score, low prostate-specific antigen (PSA) levels, and limited involvement of the prostate gland. The goal of active surveillance is to avoid or delay the side effects of treatments such as surgery or radiation therapy, which can include incontinence and erectile dysfunction.

Criteria for Active Surveillance

Patients eligible for active surveillance typically have:

• A Gleason score of 6 or less
• PSA levels less than 10 ng/mL
• Cancer confined to the prostate
• Limited number of biopsy cores showing cancer

Monitoring Protocol

The active surveillance protocol involves regular monitoring of the prostate cancer through:

• Periodic PSA testing
• Digital rectal exams (DRE)
• Repeat prostate biopsies
• Advanced imaging techniques, such as MRI

Transition to Treatment

If there are signs that the cancer is progressing, such as an increase in PSA levels, changes in DRE, or a higher Gleason score on repeat biopsy, treatment options such as radical prostatectomy or radiation therapy may be considered.

Benefits and Risks

Benefits

• Avoidance of treatment-related side effects
• Maintenance of quality of life
• Delayed need for invasive procedures

Risks

• Anxiety related to living with untreated cancer
• Potential for cancer progression
• Need for regular monitoring and biopsies

Related pages

• Prostate cancer
• Gleason score
• Prostate-specific antigen
• Radical prostatectomy

Gallery

• Prostate Cancer Risk Stratification

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