Prostate cancer active surveillance

What is active surveillance of prostate cancer?

Active surveillance has long been one of the treatment options for men with low-risk localised prostate cancer. Frequently, this option has been chosen, because the side effects of prostate cancer treatment have been thought to decrease a man’s quality of life during his lifetime more than the cancer itself would. While under active surveillance, the patient undergoes regular examinations and tests, and if the cancer shows any signs of advancing, the need for treatment will be re-evaluated.

Active surveillance or immediate treatment of prostate cancer?

Active surveillance, however, involves a risk of cancer progression, as one cannot know for sure, which of the localised cancers stay local, and which will possibly become aggressive and begin to spread. Even recent research results (Hamdy et al. 2016) have suggested that the active monitoring of prostate cancer is associated with higher incidences of disease progression and metastases than is immediate treatment. Regular surveillance biopsies also involve a risk of infection. Moreover, the high number of tests tend to increase the surveillance costs.

Today, the fact in favour of the immediate treatment of localised prostate cancer is that the use of modern tissue-internal or external radiotherapy minimises the adverse effects of the treatment. In other words, the man’s quality of life remains as good as possible, while simultaneously, it is possible to treat the cancer efficiently. The most advanced radiotherapy techniques have not even been found to involve a risk of secondary cancers.

Active surveillance at Docrates Cancer Center

If active surveillance is the best option, at Docrates Cancer Center it can be arranged individually tailored. In active surveillance, decisions are always made after a thorough discussion where the benefits and risks of surveillance are weighed. At Docrates, the discussion is attended by the patient and his family and close friends and, as necessary, a urologist and an oncologist, so that the overall understanding is as comprehensive as possible and the patient knows exactly what his situation is and how to proceed.

Active surveillance includes:

• Regular examinations: PSA testing every few months, regular MRI scans and, if necessary, new biopsies
• Reassessment of the need for treatment: If the patient’s PSA levels increase at a rapid rate, MRI scans show that the cancer is advancing or a new biopsy indicates that the prostate cancer has become more aggressive, the need for treatment will be reassessed together with the patient.