Prostate cancer continues to be the most common cancer diagnosed in men. More than 200,000 people will be diagnosed with prostate cancer this year. And while there are many successful treatment options including surgical removal or radiotherapy, sometimes the side effects of treatment include urinary incontinence and difficulties with erections. Due to these side effects, more and more patients and their physicians are exploring other options for their prostate cancer care.
Active surveillance for prostate cancer is a very reasonable option for many patients with low or sometimes intermediate risk disease. Rather than aggressively treating the prostate, patients instead undergo a series of follow up visits to keep an eye on their disease. Patients need to be willing to assume some responsibility for their care, following their PSA levels and undergoing MRI or biopsies after their initial diagnosis. This partnership between the physician and the patient allows for minimizing side effects of therapy but still ensure that if the cancer eventually needs treatment, then it still occurs before the prostate cancer has left the prostate and become metastatic. This is very different than “watchful waiting” which is not treating or following the prostate cancer and just treating it when it becomes metasatic or symptomatic, when it’s too late to cure.
Sometimes active surveillance is used to “buy time” until a patient needs more definitive therapy. Most studies find that about 50% of patients who start on active surveillance eventually need treatment. We don’t view these as failures but rather counsel patients that we’ve just delayed the side effects of treatment for several years, allowing our patients to continue to live their full and busy lives without risking leaking urine or having sexual side effects.
At Tulane we have the worlds largest group of African Americans on active surveillance and have a wide experience in managing these patients. We have developed expertise in keeping patients on surveillance, and when it’s time to remove them as well. If you have questions about your prostate cancer or would like to discuss active surveillance with one of our urologists please call the clinic at 504-891-8454 and we will see you that week to discuss your care.