Active Surveillance Programs Are Now Considered As Best Option For Early Prostate Cancer

Active surveillance programs (also known as watchful waiting) are currently recommended for patients with early stage prostate cancer.

The potential of complications and slow rate of disease development are major reasons why nowadays doctors don’t recommend surgery immediately upon the diagnosis of prostate cancer. If disease is at an early stage, it will not create any problems to the patient for many years to come. Obviously, regular medical checks and constant monitoring of PSA level should be performed. Once the signs of disease progression are observed, surgery can be considered as an option.

Due to the anatomical location of prostate gland, the surgery for prostate cancer used to be a rather difficult and not always successful procedure. Now, with introduction of robotic surgery (robotic-assisted laparoscopic prostatectomy (RALRP), the success rate is much higher. Still, in many cases the side effects of surgery can persist for years.

Choosing active surveillance instead of surgery is not an easy decision for many patients

Patients diagnosed with prostate cancer are often uneasy about leaving it as it is and doing nothing. Despite its advantages, active surveillance is often dismissed by patients facing the treatment decision.

Dutasteride (Avodart) is one of the drugs that have potential to contribute positively on this stage. This is a specific compound capable of decreasing the level of dihydrotestosterone (a derivative of testosterone, male sex hormone) in the body. Prostate cancer is sensitive to the level of dihydrotestosterone. The lowering of this hormone’s level may lead to the reduction of tumor size. Recent clinical trials indicate that dutasteride significantly delays the prostate cancer progression, and thus provides a treatment option for men with localized tumor.

Medical advice for early prostate cancer is changing

Medical regulatory bodies now start to question the wisdom of using the PSA testing systems for screening all patients. U.S. Preventive Service Task Force, for instance, recommends now against this screening. The organization argues that PSA screening may help 1 in 1,000 men to avoid dying from prostate cancer, while 4 to 5 men in 1000 will die from disease even with screening. Complete discontinuation of screening programs for prostate cancer does not look like the right decision, but it is clear that both doctors and patients should not take the higher than normal PSA readings as a signal for aggressive surgical intervention.