If you’ve been diagnosed with prostate cancer, you might feel worried about potential side effects from treatment. Since the prostate gland is located near critical areas like the bladder and bowel, treatments can sometimes lead to short-term or long-term issues with urination, bowel movements, or sexual function.
For men whose prostate cancer hasn’t advanced, active surveillance could be a suitable option. This approach involves closely monitoring the cancer rather than starting treatment right away. If the cancer is growing slowly and not progressing, other treatments can often be delayed. This means regular checkups and tests to keep an eye on any changes.
Active surveillance usually includes frequent doctor visits, blood tests to measure prostate-specific antigen (PSA) levels, physical exams like digital rectal exams (DRE), and advanced imaging such as multiparametric MRI for a detailed view of the prostate. Prostate biopsies are occasionally done to confirm findings, and sometimes even genetic testing is involved.
This option is typically recommended for men with low-risk prostate cancer, meaning the cancer is localized to the prostate and grows slowly. It might also be an option if you have other serious health concerns, such as severe heart disease, that could pose greater risks to your health than the cancer itself. In such cases, undergoing aggressive cancer treatments could worsen those existing health conditions.
The main benefit of active surveillance is avoiding or delaying the side effects of treatments like surgery, radiation, or hormone therapy, which could affect urination, bowel habits, and sexual function. By opting for active surveillance, you can maintain your quality of life while keeping a close eye on the cancer. For many men, this option safely postpones invasive treatments without compromising their health.
When considering active surveillance, it’s important to have in-depth discussions with your healthcare provider. Your age, overall health, and ability to stick to follow-up testing play critical roles in determining if this approach is right for you. Active surveillance requires commitment, such as having PSA tests done every six months and completing a follow-up biopsy within 12 to 18 months. If you’re not comfortable with the idea of living with cancer or find it too stressful, another form of treatment might be more suitable.
For many individuals, this type of care works well. Research shows that active surveillance is sufficient for about half the cases, with no need to escalate to other treatments. In the instances where cancer progresses and additional treatments become necessary, the surveillance still provides valuable time by delaying side effects. This delay can also allow time for medical advancements and more treatment options to emerge. Studies have shown that the risk of dying from prostate cancer after active surveillance remains very low.
In summary, active surveillance could be an option for managing prostate cancer, especially if your cancer is slow-growing and doesn’t immediately require intervention. It allows you to preserve your quality of life while deferring potential side effects from other treatments. Talk to your healthcare provider to determine if this approach is right for you.