Active Surveillance For Prostate Cancer

A study out of Sweden is showing men diagnosed with low risk prostate cancer can feel comfortable using active surveillance to monitor their disease.  Almost 33,000 Swedish men followed between 2009 and 2014 who had been diagnosed with very low risk - stage T1 – prostate cancer chose active surveillance to monitor it instead of other treatment methods. 

The men in Sweden did not feel the pressure to do something right away – there is more of a feeling of not rushing treatment but rather to have their low risk prostate cancer regularly checked with blood tests and biopsies gauging the growth of the tumor instead of electing for surgery or radiation until it was actually needed.

This decision among the men increased from 57 percent to 91 percent over that time period.

Active surveillance carefully monitors low grade or low risk prostate cancer for any signs of progression.  Prostate cancer considered low risk is contained in the prostate and has not spread beyond it.  During active surveillance, a PSA blood test or digital rectal exam are administered periodically and repeated biopsies of the prostate at specific intervals. It’s a means of monitoring low risk and often slow-growing prostate cancer that may not cause any problems during a man’s life instead of resorting to more invasive treatments.

This study demonstrates that low risk prostate cancer can be safely monitored by active surveillance.  Some men may eventually need some form of treatment if active surveillance is beginning to show unusual changes in the prostate.   But for other men who are not showing changes, active surveillance can preserve their quality of life for a long time as it is much less invasive than other standard treatements.

Swedish men with low risk prostate cancer are opting more and more for active surveillance when compared to American men.  In the United States, only about 40 to 50 percent of men with low-risk prostate cancer choose active surveillance.  Reasons for this include financial and legal incentives for doctors to treat patients and most Americans are not comfortable with the idea of not treating the cancer right away and to simply monitor it. 

For the year 2016 in the United States, around 181,000 men will be diagnosed with prostate cancer.  Most of those men will be diagnosed in an early stage of the disease but approximately 26,000 men will die from it during 2016. 

Men with high risk prostate cancer should seek treatment and not active surveillance.  The sooner treatment can be started, the greater the chance of saving a man’s life.