Active prostate cancer surveillance is an approach to monitor early or localized prostate cancer. It involves close monitoring rather than immediately getting started with the treatments.
The course of active surveillance includes strict monitoring of prostate cancer for changes (if any). This approach is also known as watchful waiting or wait-and-see management.
More about active prostate cancer surveillance
If you are under active surveillance, your doctor will not give you cancer treatment. It means that he/she will not prescribe any drugs, radiation, chemotherapy or surgery during that time, but will only recommend periodic tests to understand if your cancer is spreading or growing.
You’ll likely consider this procedure if the cancer is slow-growing, small, confined to a specific area of your prostate gland, or shows no symptoms. Additionally, if you have an underlying health problem that could impact your life expectancy, the active monitoring approach may be reasonable.
Are you the right candidate for active prostate cancer surveillance?
Active monitoring for prostate cancer may be the right approach for you under the following conditions:
- The extent of cancer is limited or small: If your disease was diagnosed at an early stage (when your cancer is still minor or localized), the active approach may be right for you.
- Your Gleason figure is not alarming: The Gleason grading system is a method that helps understand prostate cancer staging. The scores range from a window of 6 to 10. If your Gleason score is six or less, it indicates that your cancer is indolent (progressing slowly), low-grade, and less aggressive. In this condition, the active monitoring program may be right for you.
- You have other pre-existing health complications: If you have other health problems, such as a serious cardiovascular (heart) condition that can affect your life expectancy, and prostate cancer treatment can make them worse, active monitoring is a good idea. Be sure to notify your doctor if you have any critical health concerns.
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Why does your doctor recommend active surveillance for prostate cancer?
When the risk of your prostate cancer progressing is low, your doctor will likely recommend active monitoring to help you avoid the side effects of treatment. Prostate cancer develops very slowly. Therefore, you are less likely to experience signs or symptoms if your cancer is small. Many people lead normal lives (with a normal life expectancy) before the disease ever spreads and requires treatment.
What are the benefits of choosing active surveillance for prostate cancer?
If you are carefully screened, active surveillance can be an advantage. The benefits include:
- When you are under active supervision, you do not need treatment. This way you can avoid the side effects of cancer treatment.
- Unlike cancer treatments, this approach does not affect your daily life.
- Since you are being evaluated on an ongoing basis, your cancer treatment can begin immediately if your test reports suggest that the malignancy may be spreading.
What Are the Risks of Active Surveillance for Prostate Cancer?
The risks of active monitoring for prostate cancer include the following:
- Stress and Anxiety: Since the active surveillance phase does not involve any treatment, you may feel concerned, apprehensive and unsure about the progression and stage of the disease.
- Period of medical follow-ups: If you choose active monitoring, be prepared to see your doctor regularly.
- Cancer Progression: If the active prostate cancer surveillance strategy is not followed correctly, your cancer may progress and spread while you wait. If the malignancy spreads, you may be missing the right stage of effective treatment.
- Limited treatment options: If your cancer progresses while you are actively monitored, the number of treatment options is likely to be minimized. Also, your treatments are likely to be more extreme now than they were in the early stage of cancer.
What can you expect while under active surveillance for prostate cancer?
When you’re under active surveillance for prostate cancer, you’re likely to see your doctor regularly. The frequency can be once or twice every few months.
During these visits, your doctor may perform the following diagnostic tests and procedures:
- Digital rectal exam: During this test, your doctor checks your prostate gland through your rectum. While assessing your rectum, he/she may touch the surface of your prostate gland and assess the cancer.
- Ultrasound: If your doctor suspects something is wrong or your rectal exam suggests metastases, your doctor may be more likely to perform an ultrasound (pictures of your internal organs using sound waves) for further evaluation. During an ultrasound, your doctor will insert a small probe (which resembles a cigar in shape and size) through your rectum to see the images of your prostate gland.
- MRI (Magnetic Resonance Imaging): If your doctor suspects a progression, he or she may also perform an MRI. This diagnostic procedure takes pictures (cross section) of your prostate gland.
- Prostate biopsy: During this procedure, your doctor removes small batches of tissue from your prostate gland. It is to test the status of your cancer. Your doctor will likely recommend a biopsy after a year of active monitoring. It helps them evaluate the progression of your cancer and reevaluate your Gleason grade.
For carefully screened candidates, active prostate cancer surveillance is the most appropriate option. Not only can it help you avoid the side effects of cancer treatment, but you can get started on your treatment as soon as your test results indicate cancer progression. However, don’t miss your appointments and follow what your doctor recommends for a better outlook.
Frequently Asked Questions (FAQs)
1. Does prostate cancer spread slowly? If so, how long does it take for the malignancy to get worse?
Unlike most cancers, prostate cancer develops more slowly. Also, it probably takes about 15 years for prostate cancer to grow and affect the other parts of your body, especially your bones. In many cases, the disease is less likely to interfere with natural life expectancy.
2. A person’s Gleason score is 8. What does this mean in light of prostate cancer?
In general, the Gleason grading system uses a score range of 6 to 10. If your score is 6 or less, it means you have low-grade prostate cancer. If your score is 4, it means your cancer is of medium grade. If your Gleason score ranges from 8 to 10, it indicates that you have high-grade cancer and that it is spreading.
3. Which part of your body does prostate cancer spread to firstt?
The lymph nodes around the prostate gland are usually among the first areas to which prostate cancer spreads. If the malignancy has reached your lymph nodes at the time of diagnosis, it will likely spread quickly to the rest of your body. Therefore, you should be very careful when you are under active surveillance for prostate cancer.