New research shows jump in surveillance but not many active


For some men whose prostate cancer screening tests return positive, it’s advisable to simply watch and wait to see what the cancer will do.

This approach of closely monitoring so-called “low grade” cancer cases has grown in scientific merit, with research indicating that low-risk cancer does not inherently become high-risk cancer that could shorten a man’s life. One in seven men will be diagnosed with prostate cancer. Between 1990 and 2009, 7-14 percent of men opted for surveillance over treatment. That number jumped to 40 percent between 2010 and 2013—and 76 percent of men 75 or older chose this option.

But the report, published in the journal, JAMA Internal Medicine, also showed that most men on the “watch and wait” list aren’t doing much watching.

Between 6.5 and 12 percent of those who participated in a study of nearly 190,000 men with prostate cancer participated in proactive surveillance of their disease.

The most telling indicator of whether prostate cancer is high risk is the Gleason score, which is determined through a test of tissue following a biopsy.

Monitoring prostate cancer versus treating it directly falls into two categories, according to the American Cancer Society. “Active surveillance” includes regular PSA testing, digital rectal exams and ultrasounds to determine of the cancer is growing. “Watchful waiting,” while similar in terms of testing, is typically less intensive and invasive.

Although doctors don’t always take the same approach to this strategy of addressing prostate cancer—or have the same opinion about watchful waiting or surveillance—it is important for patients to remain proactive in participating in follow-up appointments and taking an active role in their care, in case the cancer does begin to spread.