Prostate Cancer Foundation - Active Surveillance
Active surveillance (also known as "observation" or “watchful waiting”) is an active program for closely monitoring the progress of your cancer through regular check-ups every 4-6 months. The goal is to forgo invasive treatment in men with low-grade prostate cancer, while monitoring progression of the disease allowing intervention at a time when it is necessary and a chance for cure is still possible. Active surveillance requires regular screening tests such as a digital rectal exam, PSA Test, or PCA3 Test, or biopsies. If there is evidence that cancer is progressing, treatment is recommended with the intention of curing the disease.
Active surveillance is the least physically demanding and least invasive treatment option currently available for prostate cancer. However, some men may find it mentally and emotionally stressful to observe cancer rather than attempting to cure it. In fact, many men who elect active surveillance will abandon this method sooner than is clinically necessary.
Prostate cancer is the most prevalent male cancer, but the majority of men with the disease do not die of prostate cancer. Studies suggest that 30-50 percent of men over the age of 60 years diagnosed with prostate cancer today by PSA screening undergo a treatment that will not extend their life or improve its quality. This does not mean that prostate cancer does not kill men, but rather that some men who are older and/or in poor health with a slowly progressive form of the disease, may not need immediate treatment. The key is to identify the men who for now can safely forego treatment that will have potentially life-altering side effects.
Whether or not you choose active surveillance is dependant upon a number of factors including your:
Low-grade, well-differentiated cancers tend to be the least aggressive and slowest-growing and are good candidates for active surveillance. Also, men who are at a late life stage with slow-growing prostate cancer may not experience serious physical effects of prostate cancer in their lifetime.
Active surveillance is not without risks. Occasionally a cancer that appears to be slow-growing and non-threatening will prove to be much more aggressive than anticipated. If this were the case, the cancer might advance beyond the point were it could be successfully treated. Frequent check-ups and regular observation help to prevent this from happening.