When watching and waiting is the best prostate cancer treatment

One in eight men will be diagnosed with prostate cancer in their lifetime, according to the American Cancer Society. Risk of locally advanced or metastatic disease is what drives treatment decisions. In low-risk cases where the prostate cancer isn’t likely to spread or progress quickly, active surveillance is commonly used.

“Active surveillance involves monitoring a male individual with prostate cancer for signs of cancer progression,” explains Dr. Jeffrey Tomasini, a urologic surgeon at Aurora Health Care. “In these cases, we generally perform a prostate-specific antigen (PSA) blood test and digital rectal exam every 3 to 6 months. Prostate biopsy is often guided by MRI imaging for both understanding the patient’s risk as well as targeting the biopsy.”

Dr. Tomasini says the frequency of these tests depends on the individual’s risk factors.

“Active surveillance is an ideal approach for men with low-risk prostate cancer,” he says. “It allows them to continue living their day-to-day life without undergoing surgery or radiation immediately after diagnosis. However, if the cancer is reclassified to intermediate or high-risk while on surveillance, the recommendation is for active treatment.”

Prostate cancer generally does not cause any symptoms in its early stages, which is when it has the highest probability of a cure. Once you develop symptoms from the cancer, such as unexplained weight loss, bone pain, or urinary issues, a cure can be more challenging to attain.

“The sooner we identify prostate cancer, the better chance for a favorable outcome,” Dr. Tomasini says.

Men aged 55 to 69 should discuss with their health care provider whether prostate cancer screening is right for them.

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