1. What is Active Surveillance (AS)?
Active surveillance is when men with localized prostate cancer choose not to undergo treatment like surgery or radiation. Rather, they need to be monitored closely with regular and frequent doctor visits as well as blood work and scans possibly. This includes repeating the prostate biopsy every 1- 2 years. This clearly does not mean you are doing nothing when you undergo active surveillance.
2. Who are candidates for Active Surveillance?
Men who have disease categorized to have a relatively low risk of their prostate cancer spreading outside the prostate. There are a variety of factors that are used to determine what one’s risk is including modern genetic tests that can help predict how aggressive the cancer is.
3. Does active surveillance result in the same survival as for men who underwent surgery or radiation therapy?
Based on recently published studies, the long term survival rate was the same for these two groups. However, the majority of the men (75%) in the active surveillance group eventually progressed and did undergo an treatment with surgery or radiation therapy.
4. What are the advantages of Active Surveillance?
Active surveillance allows these men to delay treatment and therefore delay the possible side effects of treatment including impotence or incontinence. This is important for many men who may feel adamant about risking their potency. For some men who are older and have other serious health conditions, active surveillance could spare them from active treatment if they die from other causes before their prostate cancer becomes a problem.
5. What are the disadvantages of Active Surveillance?
Patients undergoing Active Surveillance require close monitoring with frequent doctor visits, testing such as bloodwork and scans, and repeat prostate biopsies. There is risk of the prostate cancer progressing to more advanced stages if these men are not following their appropriate care. Therefore, it is critical that men undergoing active surveillance remain "active" with their follow up care!