Page 2 - Active Surveillance for Prostate Cancer
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Active surveillance for prostate cancer
Active surveillance
men will notice some increased urge to void as well as
During active surveillance, the cancer is carefully an increased need to void during the day or night. These
monitored for signs of progression. This usually includes changes are often short-lived but some patients will
a PSA blood test and rectal examination several times notice permanent changes to their bladder function and
a year to determine any significant changes. It is felt by may develop urinary leakage. In the longer term, many
many doctors that the rate of change of the PSA test men having radiation therapy may also lose the ability to
is a good indication that the prostate cancer may be have natural erections.
becoming more aggressive. Other tests (such as CT scans
and MRI) may also be advised in special circumstances
but are usually not a routine investigation in an active Who should consider active
surveillance program. However, your doctor may suggest surveillance?
a repeat prostate biopsy between one and two years
after your diagnosis to try and confirm that your cancer is The option of active surveillance can sometimes be a
low risk. difficult one to understand and accept. Every man’s
circumstances are unique, and there is no magic
If symptoms develop, or if any of tests indicate that the formula to help decide whether active surveillance
cancer is growing, treatment such as surgery or radiation is right for you. In general, active surveillance can be
might be then warranted. The benefit of an active considered a reasonable option for older men with
surveillance approach is being able to avoid the risks and other health issues and are diagnosed with early and
complications of treatment, at least for many years, and lower risk prostate cancer. Many of the treatment
only undergoing treatment if it is felt that your cancer is options for prostate cancer can be difficult to endure,
becoming more aggressive. and the healthier you are going into treatment, the
more likely you are to have better outcomes. Especially
Although it appears to be safe to delay treatment with if you have other health issues, such as heart disease,
surgery or radiation in many men with lower risk prostate long-standing high blood pressure, or poorly controlled
cancer, it can be difficult to accurately predict if, and diabetes, active surveillance may allow you to avoid the
when, your cancer will become more aggressive. risks and complications of treatment if the cancer does
not progress. To put things bluntly, these men are likely
Side effects of surgery and radiation to have fewer symptoms related to their disease and
are more likely to die with prostate cancer than die of
The other available treatment options for prostate prostate cancer.
cancer, including surgery and radiotherapy, can have
serious, long-lasting effects on your quality of life. In the Some younger men diagnosed with lower risk prostate
longer term, many men having a radical prostatectomy cancer may choose active surveillance in order to delay
may lose the ability to have natural erections. Also, or possibly avoid the potential side effects of therapy
some degree of urinary leakage after prostate surgery is such as incontinence and erectile dysfunction. It is
common requiring protection in the form of pads and, important to realize this is a program of close observation
rarely, additional surgery to restore control. with an option to choose active treatment at any point
if it is felt the cancer is progressing. The potential for the
Similarly, radiation to the prostate can have early and cancer to grow and spread during active surveillance
more delayed side effects. Radiation to the rectum often could be a concern. Some men find it stressful to know
causes increased number of bowel movements and they have cancer and may find it difficult to delay active
some blood in the stool, although this often clears up treatment.
soon after treatment. Radiation can occasionally cause
a variety of long-term problems with the bowels including Discussing the pros and cons of the different treatment
inflammation of the rectum (proctitis), with bleeding and options with your physician and family can help you
bowel problems such as diarrhea. It is common to notice confidently choose the right treatment for you.
changes in your voiding pattern during radiation. Most
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