Prostate Cancer Surveillance

What is Surveillance for Prostate Cancer?

You may already know that prostate cancer is a very slow process.  Unlike some other types of cancer, it takes a long time for most prostate cancers to grow and spread.  Over the past 2 or 3 decades we have learned that, because of the slow nature of prostate cancer and the fact that it is usually found in older men, many (if not most) men with prostate cancer will not die from prostate cancer.  Therefore, many men with prostate cancer do not need immediate treatment or will never need any treatment at all.  For these men, it is often the best approach to simply “keep an eye on things” and put off treatment or avoid it altogether.  “Keeping an eye on things” is called active surveillance.

How Does Active Surveillance Work?

If you have prostate cancer, your urologist will talk to you at length about all the options that are available.  He or she will often recommend active surveillance if it seems to be the right thing for you.  The idea is to closely monitor the cancer to be sure it is not growing or spreading.  If there are signs of growth, your urologist will talk to you about moving on to surgery or radiation before things get out of hand.

In order to monitor the cancer, you will need periodic PSA blood tests.  PSA is usually checked every 3 months during the first year and every 6 months thereafter.  PSA is a good indicator of prostate cancer growth.  In addition, you should have a prostate exam at 6 months and 1 year and every year thereafter.  Finally, repeat prostate biopsy is usually recommended every 2 or 3 years depending upon how things are going.  Additional tests such as CT scan, bone scan or MRI might be recommended in certain circumstances.

Is Active Surveillance Right For Me?

Deciding what to do about prostate cancer can be difficult.  Many men are relieved to know that they do not have to have surgery or radiation.  Other men have a lot of anxiety and worry if they are not doing something about prostate cancer.  Men with the following might want to consider active surveillance:

  • Low grade prostate cancer

  • Small amount of prostate cancer in the prostate

  • PSA less than 10

  • Age over 70 years

  • Other health problems that might shorten one’s life

By following a program of active surveillance, many men can avoid treatment altogether and live a normal life with no problems from prostate cancer.  Other men can put off treatment, often for many years.  This is important because treatment for prostate cancer (like treatment for any kind of cancer) has risks or side effects.  Obviously, if you can avoid the treatment, you avoid the risks.

It is also important to know that active surveillance is safe.  If the cancer starts to grow, we will know about it in plenty of time to do something before it is too late.

We hope this gives you a little insight into active surveillance for prostate cancer.  Call Gallatin Urology (406-551-2306) for an appointment if you have more questions or are concerned about prostate cancer.