Active Surveillance
The goal is to no longer cure you of the cancer but simply follow it. The bet is that the cancer is so slow growing it isn't a long-term threat even if it does progress - Adam Stuart Kibel MD
HWN Suggests
Long-Term Outcomes in Patients Using Protocol-Directed Active Surveillance for Prostate Cancer
Active surveillance emerged as a management approach for favorable-risk prostate cancer in response to overtreatment of indolent disease that resulted with the introduction of prostate-specific antigen (PSA) screening. This strategy involves monitoring with clinical examinations, serum PSA, periodic biopsies, and, more recently, multiparametric magnetic resonance imaging (MRI), such that definitive treatment with surgery or radiation is either delayed until there are signs of cancer progression or avoided altogether if no progression is detected, mitigating common adverse effects associated with treatment, such as urinary incontinence, urinary irritative symptoms, and erectile or bowel dysfunction.…
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Time to stop active surveillance?
Men with low-risk prostate cancer can stay on it for years, but there comes a time when they should consider other options.
Articles of Interest
Active Surveillance for Low-Risk Prostate Cancer Continues to Rise
Most prostate cancers diagnosed with PSA-based screening, which became widespread in the United States starting in the early 1990s, are low-risk. Generally speaking, that means they are small, confined to the prostate, and not considered to be aggressive according to a common grading system known as the Gleason score. Nevertheless, throughout the 1990s and well into the 2010s, many men diagnosed with low-risk prostate cancer had immediate treatment with surgery or radiation.
Active Surveillance of Prostate Cancer: Use, Outcomes, Imaging, and Diagnostic Tools
Active surveillance (AS) has emerged as a standard management option for men with very low-risk and low-risk prostate cancer, and contemporary data indicate that use of AS is increasing in the United States and abroad. In the favorable-risk population, reports from multiple prospective cohorts indicate a less than 1% likelihood of metastatic disease and prostate cancer-specific mortality over intermediate-term follow-up (median 5 to 6 years).
Active surveillance review: contemporary selection criteria, follow-up, compliance and outcomes
The primary goal of active surveillance (AS) is to prevent overtreatment by selecting patients with low-risk prostate cancer (PCa) and closely monitoring them so that definitive treatment can be offered when needed. With the increasing popularity of AS as a management strategy for men with localized PCa, it is important to understand all the contemporary guidelines and criteria that exist for AS and the differences among them. No single optimal management strategy for clinically localized, early-stage disease has been universally accepted.
Before Prostate Surgery, Consider ‘Active Surveillance’
Not to be confused with “watchful waiting,” active surveillance is not a do-nothing approach.
Is active surveillance the answer?
Prostate cancer is the most common cancer in American men, with one in eight being diagnosed with the disease at some point in their lives. At the same time, 90% of men who have prostate cancer will live on because the cancer remains localized and does not spread to other parts of the body. They will ultimately die of something else. This is defined as low-risk prostate cancer.
Men With Prostate Cancer Can Thrive for Years With Less Aggressive Treatment
Mortality in large study was equivalent whether men underwent surgery, radiation or surveillance.
More Men With Early Prostate Cancer Are Choosing to Avoid Treatment
Seemingly overnight, treatment of men with early-stage prostate cancer has undergone a sea change. Five years ago, nearly all opted for surgery or radiation; now, nearly half are choosing no treatment at all. The approach is called active surveillance. It means their cancers are left alone but regularly monitored to be sure they are not growing. Just 10 percent to 15 percent of early-stage prostate cancer patients were being treated by active surveillance several years ago. Now, national data from three independent sources consistently finds that 40 percent to 50 percent of them are making that choice.
Some men with prostate cancer should be offered surveillance, not treatment
This article is more than 11 years old Some men with prostate cancer should be offered surveillance, not treatment This article is more than 11 years old National Institute for Health and Care Excellence says monitoring might be better than radical surgery or radiotherapy Press Association Tue 7 Jan 2014 19.09 EST Share Some men with prostate cancer should be offered "surveillance" rather than treatment, according to NHS guidance. Doctors treating sufferers deemed to have intermediate or low risk prostate cancer should consider monitoring rather than radical surgery or radiotherapy, according to updated guidance from the National Institute for Health and Care Excellence (Nice). Prostate cancer can be slow growing and many men will have cancer that will not cause them any harm in their lifetime, Nice said.
Time to stop active surveillance?
Men with low-risk prostate cancer can stay on it for years, but there comes a time when they should consider other options.
Why Observing Prostate Cancers Is Gaining Ground On Surgery
Some think these tumors should be rebranded as something else, such as idle tumors, to reflect the fact that they're not all that threatening and don't necessarily need to be treated. The analogy, though imperfect, is that some early skin cancers are called "actinic keratoses" and early cervical cancers are termed "dysplasias."
