Active Surveillance for Prostate Cancer | Prostate Cancer Staging Guide

PCRI’s Executive Director, Mark Scholz, MD, gives an overview of active surveillance, a monitoring strategy for men with low-grade prostate cancer. He discusses it's benefits, who is eligible, and how it is performed.

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0:49 Why do men choose active surveillance? When looking at low-grade disease, the risks and side effects of treatment are too severe to justify. Avoiding treatment can avoid complications. Technology is advancing rapidly, treatments improve, and imaging and genetic tests get more accurate as time goes on.

2:00 How is active surveillance is performed? Previously, men had to have repeated random biopsy because of a lack of quality imaging. Modern 3T mpMRI is now shown to be more accurate than random biopsy. It’s less invasive and doesn’t cause the same complications that random biopsy does. PSA is also used to monitor cancer, but it is not relied upon as heavily as scans and biopsies. PSA requires interpretation to be useful for monitoring. PSA is done every 3-6 months, and Imaging is done annually, eventually, men can graduate to every other year.

4:23 Who is eligible for active surveillance? The criteria have been evolving over the past few years. Traditionally men who have 3+3=6 were eligible for active surveillance. Modern studies show that men with 3+4=7 where the amount of grade 4 is less than 20% can also do active surveillance. Generally, PSA should be below 10 depending on the size of the prostate and other prostate conditions.

5:48 Why is active surveillance is controversial? Low-grade cancer is still being treated with radical therapy. It is difficult for men to withhold treatment from a condition called cancer. Additionally. Doctors are trained to give treatment, so it is more natural for them to do so. This also potentially lowers their liability. However, science shows that active surveillance is safe for men who qualify for it. It is a new development, and the medical field is just catching on.

7:18 Summary

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The Prostate Cancer Research Institute (PCRI) is a 501(c)(3) not-for-profit organization that is dedicated to helping you research your treatment options. We understand that you have many questions, and we can help you find the answers that are specific to your case. All of our resources are designed by a multidisciplinary team of advocates and expert physicians, for patients. We believe that by educating yourself about the disease, you will have more productive interactions with your medical professionals and receive better-individualized care. Feel free to explore our website or call our free helpline at 1 (800) 641-7274 with any questions that you have. Our Federal Tax ID # is 95-4617875 and qualifies for maximum charitable gift deductions by individual donors.

The information on the Prostate Cancer Research Institute's YouTube channel is provided with the understanding that the Institute is not engaged in rendering medical advice or recommendation. The information provided in these videos should not replace consultations with qualified health care professionals to meet your individual medical needs.

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