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What Is Active Surveillance for Prostate Cancer



Prostate cancer is one of the most common types of cancer we see at Kansas City Urology Care. Many times, low-grade or slow growing cancers stay confined to the prostate and can take years to become a problem. This type of cancer may need minimal or even no treatment. However, other types of prostate cancer are aggressive and can spread very quickly. So how do we take care of the fast-growing cancers without performing surgery to remove all prostate cancers?

Active Surveillance Means Keeping a Close Eye on the Prostate
Because low-grade prostate cancers may take many years to grow, active surveillance is a decision to carefully and safely watch prostate cancer very closely so if there are life threatening changes, they are caught as soon as possible. Prostate cancer that’s detected early – when it’s still confined to the prostate gland – has the best chance for successful treatment. Combine this with the fact that some treatments have potential side effects including hormonal changes, diarrhea, fatigue, nausea & vomiting, infertility, urinary incontinence, and erectile dysfunction and you can see why it makes sense to put off treatment, but keep a close eye on the problem. 

Who Can Qualify for Active Surveillance?
Research indicates that immediate prostate cancer treatment may be safely deferred for a subgroup of healthy men with very low-risk prostate cancer. Experts differ as to who exactly may qualify for active surveillance, but most suggest that it is appropriate for men with no more than one or two positive biopsies of Gleason 6 cancer, as long as there is not too much cancer in the positive biopsy core(s). 

What Does Long Term Follow-up Entail?
If a man decides not to pursue immediate treatment, a critical element of active surveillance is appropriate long-term follow-up, PSA testing, and prostate biopsies. PSA (prostate-specific antigen) is a protein produced by normal, as well as malignant, cells of the prostate gland. The PSA test measures the level of PSA in the blood. The blood level of PSA is often elevated in men with prostate cancer.

Treatment May Still Be Necessary Down the Road
Your urologist will advise you of your schedule for follow-up care. A small group of healthy men with very low-risk prostate cancer who are under active surveillance will eventually require treatment due to cancer growth. This is determined by follow-up PSA and prostate biopsy results.

There are many factors to consider when deciding which treatment to choose for your prostate cancer. These decisions should be made in conjunction with your doctors, especially your urologist. 

At KCUC, we specialize in offering personalized cancer treatment in a supportive, knowledgeable, accurate, friendly and courteous way.  We offer state-of-the-art treatments in a modern facility, so you can get in and out quickly, but in a setting, that’s relaxing and less stressful than a hospital.  We have some of the top Kansas City urologists and oncologists to help support you with multiple locations in Kansas and Missouri.  Visit us at www.kcuc.com.