June 24, 2019—Only a small number of men who choose active surveillance for early prostate cancer treatment follow through with the recommended surveillance guidelines, a new study suggests.
Failing to follow the guidelines could put a man at risk for a cancer that grows undetected.
A low-risk treatment option
Prostate cancer often grows very slowly, and many men who are diagnosed with it will never need treatment. If a man's prostate cancer is deemed low risk, he and his doctor might choose to monitor it closely with active surveillance rather than immediate treatment.
That's because treatment—with surgery or radiation—can have risks and side effects that may make monitoring the cancer the better option.
The importance of follow-through
For active surveillance to be effective, patients must stick to a set of testing guidelines. This study used surveillance guidelines from the National Comprehensive Cancer Network. They call for:
- A prostate-specific antigen test at least every six months.
- Annual rectal exams.
- A repeat biopsy within 18 months of diagnosis.
The study found that only 15% of men followed all these guidelines. Researchers found no link between successful patient participation and income, race or age.
Active surveillance vs. watchful waiting
Watchful waiting is another option for low-risk prostate cancer. But it requires less intensive testing than active surveillance. And it's more focused on easing symptoms, not curing cancer.
The American Cancer Society notes that not all doctors agree on what these terms mean. Some doctors don't even use the term "watchful waiting" anymore. It can suggest that nothing is being done when, in fact, the cancer is being monitored.
If your doctor recommends active surveillance for your prostate cancer, you should:
- Ask exactly what your doctor means and have the treatment clearly explained to you.
- Set up a schedule for your tests right away so that you don't miss any.
Know your options
Deciding what treatment is right for you can be a complex process. Learn more about the treatment options available for prostate cancer.