Active surveillance safely monitors low risk prostate cancer - Dr. David B. Samadi

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Active surveillance safely monitors low risk prostate cancer

Active surveillance safely monitors low risk prostate cancer

A diagnosis of any type of cancer is scary with a natural reaction to get the cancer out as soon as possible.  Men diagnosed with prostate cancer will usually have this same response but not all prostate cancers are the same – some will be very aggressive and will be more likely to spread to other areas of the body while some may barely grow at all and pose less threat. 

Prostate cancer in men found to be growing very slowly, may never need to be treated.  Instead, an approach a doctor may use in this circumstance is called active surveillance.

Active surveillance means to monitor the cancer closely where the doctor may do a prostate specific antigen blood test (PSA) and a digital rectal exam either every six months or yearly.  Watchful waiting is another term some doctors use and may mean a less intensive type of follow-up relying on fewer tests and relying more on changes in a man’s symptoms deciding then if treatment is needed.

Study shows active surveillance effective for monitoring prostate cancer

A study out of Sweden is showing men diagnosed with low risk prostate cancer can feel comfortable using active surveillance to monitor their disease.  Almost 33,000 Swedish men followed between 2009 and 2014 that had been diagnosed with very low risk - stage T1 – prostate cancer chose active surveillance to monitor it instead of other treatment methods. 

The men in Sweden did not feel the pressure to do something right away – there is more of a feeling of not rushing treatment but rather to have their low risk prostate cancer regularly checked with blood tests and biopsies gauging the growth of the tumor instead of electing for surgery or radiation until it was actually needed.

This decision among the men increased from 57 percent to 91 percent over that time period.

Active surveillance carefully monitors low grade or low risk prostate cancer for any signs of progression.  Prostate cancer considered low risk is contained in the prostate and has not spread beyond it.  During active surveillance, a PSA blood test or digital rectal exam are administered periodically and repeated biopsies of the prostate at specific intervals. It’s a means of monitoring low risk and often slow-growing prostate cancer that may not cause any problems during a man’s life instead of resorting to more invasive treatments.

This study demonstrates that low risk prostate cancer can be safely monitored by active surveillance.  Some men may eventually need some form of treatment if active surveillance is beginning to show unusual changes in the prostate.   But for other men who are not showing changes, active surveillance can preserve their quality of life for a long time as it is much less invasive than other standard treatments.

Swedish men with low risk prostate cancer are opting more and more for active surveillance when compared to American men.  In the United States, only about 40 to 50 percent of men with low-risk prostate cancer choose active surveillance.  Reasons for this include financial and legal incentives for doctors to treat patients and most Americans are not comfortable with the idea of not treating the cancer right away and to simply monitor it. 

For the year 2017 in the United States, around 161,360 men will be diagnosed with prostate cancer.  Most of those men will be diagnosed in an early stage of the disease but approximately 26,730 men will die from it during 2017 

Keep in mind, men with high risk prostate cancer should seek treatment and not active surveillance.  The sooner treatment can be started, the greater the chance of saving a man’s life.


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