Active Surveillance for Low-Risk PCa: Sprint or Marathon?

Active surveillance for low-risk prostate cancer is a strategy that involves monitoring the cancer without immediate treatment. The length of time a patient remains on active surveillance varies depending on factors such as the patient's comfort level, changes in prostate-specific antigen (PSA) levels, and results of imaging tests. Studies show that roughly half of men in the United States who choose active surveillance abandon it within 5 years, often due to the discovery of a more aggressive cancer. However, the use of magnetic resonance imaging (MRI) has improved the accuracy of staging the disease and has led to a decline in the dropout rate. Factors such as age, overall health, and the presence of certain mutations can also affect the longevity of active surveillance. Urologists have varying philosophies on the use of active surveillance, with some cautioning against it for younger patients with higher-grade cancers. Ultimately, the decision to pursue active surveillance should be made in partnership with the patient, considering the individual's unique circumstances. [Extracted from the article]