If you have been diagnosed with prostate cancer, you may be familiar with common treatment options that include surgery and radiation. However, another approach called "active surveillance" or "watchful waiting" might be an option if you have low-risk prostate cancer. Low-risk prostate cancer may not require treatment.
"In active surveillance, rather than receiving immediate treatment for low-risk prostate cancer, your cancer care team watches your condition closely," says Dr. David Hall, a Sharp Rees-Stealy Medical Group double board-certified internal medicine and pediatrics doctor. "Your cancer care team typically includes specialists such as a urologist, radiation oncologist and medical oncologist. If tests show that your cancer is getting worse, they will recommend treatment."
Low-risk prostate cancer
Dr. Hall says typical low-risk prostate cancers are:
- Small tumors
- Contained within the prostate
- Likely growing so slowly that it will not become life-threatening
"Statistically, most patients with low-risk prostate cancer, even if it is untreated, will die of something else," says Dr. Hall.
Why consider active surveillance?
Active surveillance may help improve a man's quality of life if he has low-risk prostate cancer. Treatment is not necessary for many patients, enabling them to avoid the side effects of treatment, which can include sexual, urinary and bowel problems.
"Choosing the active surveillance approach means you will have regular checkups, including a prostate specific antigen (PSA) test and rectal exam," says Dr. Hall. "You would undergo a prostate biopsy if needed and can start treatment at any time if the cancer starts to grow."
When immediate treatment for prostate cancer is recommended
Prostate cancer that is advanced or high-risk may not be appropriate for active surveillance. You should talk to your cancer team if your prostate cancer shows signs of being high-risk and needs treatment right away, including:
- PSA value that is high or rapidly rising
- Test results showing that the tumor is outside the prostate gland, or the tumor is growing rapidly and is likely to spread outside the gland
- Gleason score is high-risk
"It's important to keep in mind that some men may benefit from having a low-risk tumor treated right away, even if they may experience side effects," says Dr. Hall. "Discuss your treatment options and quality-of-life issues with your cancer care team, who will be an important source of advice as you consider all of your options."
At Sharp Rees-Stealy, we want to empower you to make well-informed choices about cancer tests and treatments for your family. That's why we've made it our priority to support our doctors in helping you make smart and effective decisions by participating in Choosing Wisely®.
Choosing Wisely, an initiative of the ABIM Foundation, educates patients and doctors on selecting the most effective treatment available and avoiding unproductive, costly procedures. Sharp Rees-Stealy is the only medical group in Southern California to participate in this national campaign.