But these days, if a man hears he’s been diagnosed with prostate cancer, he may not have to prepare himself for any of these treatments anytime soon. Instead, his doctor may recommend something called “active surveillance.”
This conservative option, which involves close monitoring, is often a relief to patients, says Daniel George, MD, director of genitourinary oncology for the Duke Cancer Institute. “With prostate cancer, the real issue is not the diagnosis,” he says. “It’s what you do about it when you find it.”
More and more, patients with low-volume and low grade prostate tumors are opting for a less-is-more approach. But active surveillance, as the name suggests, is not a laissez-faire strategy. The doctor checks for PSA (prostate-specific antigen) levels in the blood every three to six months. Other tests, including ultrasound, may be performed to see if any cancer is growing.
Active surveillance isn’t just up to the physician; patients have a responsibility, too. They may need to change their diet, ramp up their activity, control their weight, and take vitamin supplements. “A tremendous amount of empowerment goes along with active surveillance,” George says.
George says studies show that 60 to 70 percent of men undergoing active surveillance do not have a spread of cancer within five to 10 years. He’s eager to see longer-term studies but is optimistic so far. “The vast majority of men with prostate cancer can avoid surgery and all the possible consequences that go with it,” he says.