If a doctor tells you or someone you know has "prostate cancer," it's normal to feel a great deal of fear and shock when you hear those words. When we hear the word "cancer," we think of things like surgery, chemotherapy, and radiation therapy. But did you know that not all prostate cancers require such major treatment right away? Today, we're going to talk about a special method used in such cases.
Simply put, what is Active Surveillance?
"Active Surveillance" simply means "active observation." That is, without immediately starting surgery or radiation therapy for prostate cancer, but constantly monitoring the behavior of the cancer under the close supervision of a doctor.
The main goal of this is to delay the start of treatment until it is really needed. This method is used only for low-risk , that is, slow-growing, early-stage cancers. A recent study showed that 6 out of 10 men with low-risk prostate cancer are under this Active Surveillance method. This means that this is now a very widely used, accepted method.
Who is this Active Surveillance method suitable for?
This is not a one-size-fits-all approach. For your doctor to recommend this approach to you, your cancer must have these characteristics:
- The cancer has not spread outside the prostate gland.
- The cancer may not be aggressive , depending on the size of the tumor, its growth rate, and your Gleason score (a special method used to measure how aggressive the cancer cells are after a biopsy).
When you find out you have cancer, it's normal to feel like, 'Oh, I need to get this treated and over with quickly.' Don't be afraid to talk openly about this with your doctor.
What happens during Active Surveillance?
Under this system, you don't just stay at home. Your oncologist will check you regularly. Just like servicing a car, they will check the condition of your body regularly.
| Test | How often? (Frequency) |
|---|---|
| Digital Rectal Exam (DRE) | Usually once or twice a year |
| PSA blood test (PSA Test) | Usually once or twice a year |
| Prostate Ultrasound and Biopsy | Every 1-5 years (as determined by the doctor) |
| MRI-guided biopsy | In some cases, a doctor may recommend it. |
These tests will help your doctor monitor your cancer to see if it is getting bigger or spreading. If you develop any new symptoms or if your tests show that your cancer is growing, your doctor will talk to you and stop Active Surveillance, and refer you to appropriate medical treatment.
What are the advantages and risks of this method?
The main advantage
The biggest advantage of this is that you can live without the side effects of treatment. Surgery and radiation therapy for prostate cancer can cause things like difficulty urinating and sexual dysfunction. Active Surveillance can preserve your quality of life by delaying these treatments until they are really needed.
Risk
The main risk is that if the cancer starts to grow, there may be a delay in starting treatment. Sometimes the cancer can grow and spread to other parts of the body (metastasize). However, if you get tested at the right time, this risk can be greatly reduced. That's why this is called "active surveillance."
What is the difference between Active Surveillance and Watchful Waiting?
These two words are a bit similar, which can make some people confused. Although they are both ways of "watching", there is a big difference between them.
| Characteristic | Active Surveillance | Watchful Waiting |
|---|---|---|
| Main objective | Monitoring the behavior of the cancer to begin treatment at the right time, with the aim of curing the cancer. | Rather than curing cancer, it is about controlling the symptoms that occur. Treatment is only given if symptoms occur. |
| Tests performed | Tests such as PSA, DRE, and Biopsy are performed systematically according to a set schedule. | No systematic testing is done. Patients are only tested if they develop symptoms. |
| Who is it suitable for? | For those with healthy, longer lifespans and lower risk of cancer. | For those who are older, have other serious illnesses, and have a short life expectancy. |
When should I see the doctor?
If you are on Active Surveillance, if you develop any new symptoms (e.g., difficulty urinating, bone pain) or if your existing symptoms worsen, notify your doctor immediately. Also, be sure to attend your scheduled clinic appointments.
Take-Home Message
- Active Surveillance is a management method used for low-risk, slow-growing prostate cancer .
- The main goal here is to avoid the side effects of treatment, preserve quality of life, and delay treatment until the moment it is needed.
- This is not just a wait-and-see process, but a process in which tests such as PSA, DRE, and biopsy are performed regularly under the close supervision of a doctor .
- If signs of cancer development appear, the doctor will begin treatment immediately.
- This is a decision that you and your doctor should make together. Discuss all your concerns and fears with your doctor, and make this decision with full understanding.
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