If the doctor tells you or someone you know "has prostate cancer," what immediately comes to mind are things like surgery, chemotherapy, or radiation therapy? It's really normal to feel scared and anxious when you hear something like that. But did you know that not everyone with prostate cancer needs to start such major treatments right away? Today, we're going to talk about a method that is used in such cases, and many people don't know about it.
Simply put, what is 'Active Surveillance'?
As the name suggests, 'active surveillance' means actively watching the cancer without treatment, that is, keeping a close eye on it. This does not mean ignoring the cancer. More precisely, it means that a person with low-risk, non-malignant prostate cancer is monitored regularly to see how the cancer is doing without immediate treatment, such as surgery.
Think of it this way. There is a naughty little boy in the house. As long as he plays in the room, we have no problem. But we are always watching to see if he is going to do something dangerous, or if he is going to touch the current. Only if he tries to do something dangerous like that, do we intervene quickly. 'Active surveillance' is something like that. We wait until the cancer is in the prostate , but only if it shows signs of getting worse do we start treatment.
The main goal of this is to delay the side effects of things like surgery and radiation therapy until necessary. This will help you maintain a good quality of life.
Who is this method most suitable for?
The method called 'active surveillance' is not suitable for everyone. If your doctor suggests this method for you, several things need to be met.
- The cancer may not have spread outside your prostate gland.
- The cancer cannot be aggressive. To determine this, doctors use things like the 'Gleason score', which is a test that takes cancer cells and tests them. This score should be low.
- The tumor must be small in size.
Simply put, if you have early, slow-growing, and non-malignant cancer , this method may be a good option for you.
What happens during 'active surveillance'?
You will not be left alone during this time. Your oncologist will monitor you very closely. There is a specific plan, or 'protocol', for this. This is what usually happens during this time.
| Test / Process | The usual time frame |
|---|---|
| Digital Rectal Exam | Usually once or twice a year. |
| PSA blood test (PSA Test) | Once or twice a year. This gives an idea of the health of the prostate gland. |
| Prostate Biopsy | Once every 1 to 5 years. This is to check for any changes in the cancer. |
| MRI scans | Sometimes, the doctor may also recommend an MRI scan to guide the biopsy. |
This schedule may vary depending on your condition. The most important thing is to follow your doctor's instructions exactly and not skip any tests.
What are the advantages and risks of this method?
As with any medical procedure, there are both benefits and risks. It is important to understand both before making a decision.
Benefits
The main advantage is the opportunity to avoid or delay side effects that can occur with things like surgery and radiation therapy. For example:
- Difficulty controlling urine (urinary incontinence)
- Erectile dysfunction
- Infections and pain
It's a great thing to be able to live your life normally, without things like this.
Risks
The main risk is that the cancer may grow and spread (metastasize) during the waiting period. If that happens, subsequent treatment may be more complicated. However, this risk can be largely managed by having regular checkups.
It's normal to feel scared and anxious about not getting treatment for cancer even though you know you have it. You may think, "Oh, I don't know if this will grow inside me." If you feel that way, talk to your doctor about it openly. He or she will understand your feelings.
What is the difference between 'active observation' and 'watchful waiting'?
Many people confuse these two words because they are somewhat similar. However, there is a big difference between these two methods.
| Characteristic | 'Active Surveillance' | 'Watchful Waiting' |
|---|---|---|
| Main objective | Waiting for the best time to begin treatment, with the aim of curing the cancer. | The goal is not to cure cancer, but to control symptoms and maintain a good quality of life. |
| Testing | Tests like PSA and biopsy are performed regularly . | Regular testing is not done and symptoms are treated only if they appear. |
| Most suitable | For those who are relatively young, healthy, and can expect to live a long life. | For the elderly, those with other serious illnesses, and those who have difficulty tolerating the side effects of treatment. |
Simply put, 'Active Surveillance' means being vigilant and waiting for treatment. 'Watchful Waiting' means not treating the symptoms and only treating them if they occur.
What time should I talk to the doctor?
During the 'active surveillance' period, it is very important that you pay attention to changes in your body. If you develop any new symptoms, or if you feel that an existing symptom is getting worse, let your doctor know right away .
For example,
- More difficulty than usual when urinating
- Frequent need to urinate
- Back or bone pain
Be careful about things like: Never be afraid to ask your doctor about any questions you have, no matter how small. You also have a big role in making decisions about your treatment.
Take-Home Message
- 'Active Surveillance' is a management method used for non-malignant, slow-growing prostate cancer.
- The goal here is not to ignore the cancer, but to delay the possible side effects of treatment until necessary.
- During this period, regular medical tests (PSA, biopsy) are performed to closely monitor the behavior of the cancer.
- It's normal to feel scared or anxious about not having cancer and not getting treatment. It's important to talk openly about this with your doctor.
- This is different from the approach called 'watchful waiting'. The goal of 'active surveillance' is to treat and cure the disease if necessary.
- Before making a final decision, carefully discuss the benefits, risks, and whether this method is right for you with your doctor.
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