As you surf the net looking for guidance about prostate cancer, pay attention to the “source.” “Consider the source, John,” my mother would say. In this article the reference is the Journal of Urology. That is as good as it gets in terms of legitimate studies. That is much different from a review from an online reporter or the views of a blogger. (Did I just say that….bloggers other than me I meant.)
The upshot? Active surveillance is a reasonable option for the right patient and the right biopsy parameters. Most (“most” doesn’t mean “all”…be careful with these words) men who are candidates will never have a treatment. Those that do fall out of surveillance because of a change or worsening of the parameters ( change in volume on a subsequent biopsy, upgrading of the Gleason’s, or a PSA velocity change), in most cases nothing is lost or harmed by waiting to then pursue a therapy. The significance of which is that one might gain several years of quality of life. I personally could not ” wrap my mind around surveillance” and chose to be proactive in my decision, however I totally acknowledge the benefit of active surveillance and recommend it to my patients as a “treatment” option.