Active Surveillance for Prostate Cancer

Doctors may recommend postponing therapy immediately after diagnosis. When low risk cancer is confined to the prostate, it can be closely monitored with PSA tests, physical exams, serial biopsies, and, more recently, MRI imaging. This process is known as “active surveillance with curative intent.” In this strategy, patients only receive active treatment if the cancer becomes more aggressive. With this approach, you can delay the side effects of treatment or even avoid them altogether. Active surveillance is an option for some men, although not every patient chooses this course of action.

In addition, the strategy of “watchful waiting” is sometimes used in specific situations. When a patient is particularly elderly or ailing, the risk of treatment may outweigh the potential benefits. “Watchful waiting” involves monitoring the situation, but not doing active testing (such as biopsies). Action is only taken if the cancer begins to cause symptoms.

In fact, in the active surveillance cohort, with long-term follow-up, the chance of dying from untreated prostate cancer is one in a thousand, which is similar to the chances of dying from similar risk prostate cancer if it was treated.

Key points in favor of active surveillance include:

  • Active surveillance is safe and patients will get treatment if it is truly needed.
  • Patients can put off or forego side effects for a number of years without impacting their survival rate.
  • Active surveillance gives patients the option for safer and better therapies in the future as the field rapidly changes

Being Proactive When on Active Surveillance

Exercising several times a week has been shown to improve physical, as well as emotional, health.  Always make sure you talk with your doctor first before starting any new exercise routine.

Utilize your Support System
Make time for family and friends, stay connected. Watch out for tendencies to withhold your needs for fear of burdening others. 

Eat Healthy
In addition to weight-related goals, maintaining a healthy diet will help to boost your energy and your immune system’s ability to fight illness. 

Schedule Self-care
Engage in activities you find enjoyable or that rejuvenate you – such as cooking, reading or listening to music. While this may seem obvious, we don’t often actively make time for self-care, but rather expect it to just happen after our “to do” list is completed. 

Keep a Journal
Evidence has shown that expressive writing, whether it’s daily or occasional, can help individuals clarify their thoughts as well as reassess and reprioritize their needs. 

Get Just the Right Amount of Information
The Internet is an amazing tool. It’s invaluable in gathering and sorting out complex and often novel, health-related information.  But you must be aware that it can be a slippery slope and one can easily find themselves lost in a sea of information, not all reliable and reputable.