Prostate Cancer: What is ‘Active Surveillance’?

Prostate Cancer Treatment
Print icon

While it may seem passive, the “active surveillance” approach to treating prostate cancer requires a very diligent monitoring process.

Dr. Stuart Kesler, a urologist with the Hartford HealthCare Tallwood Urology & Kidney Institute, says that even when prostate cancer is discovered, there isn’t always a need to start treatment immediately. Often, the disease is localized, meaning it is only in the prostate and hasn’t spread to other parts of the body. And, for many men, it doesn’t come with symptoms or related problems at first, and sometimes never causes symptoms.

“We know that many treatments for prostate cancer, including radiation or surgery,” says Dr. Kesler, “can cause significant side effects, so we believe that if the cancer is not considered high risk to spread or cause death, we might not have to treat it immediately.”

Tests can reveal if the prostate cancer is low-, medium- or high-risk, indicating the chance that it will grow or spread. Whatever the risk level, the disease does need to be monitored. Men with low-, and sometimes even medium-risk prostate cancer, Dr. Kesler says, can use “active surveillance” knowing that if concerning changes are found, treatment can begin.

“Some prostate cancers are slow growing and may never cause the man any problems,” he says. “Other times, the cancer is at higher risk to progress and then we will discuss treatment options.”

Symptoms both patient and doctor look for include:

  • Trouble urinating or urinary retention.
  • Increased need to urinate.
  • Decreased flow during urination.
  • Trouble starting or stopping the urine stream.
  • Blood in semen.
  • Bone pain.

Dr. Kesler notes that having one or more of these symptoms does not automatically mean you have prostate cancer since an enlarging, non-cancerous prostate and other diagnoses can also cause some symptoms.

During the surveillance period, a doctor monitors your health with regular tests such as:

  • Digital rectal exam to feel the surface of the prostate for bumps that could be tumors.
  • Prostate specific antigen (PSA) test to monitor the level of the PSA protein in your blood.
  • Imaging test such as magnetic resonance imaging (MRI) and ultrasound to see if the disease has spread beyond your prostate.
  • Biopsy of the prostate.
  • Surveillance must be done judiciously, however, because delaying treatment too long can sometimes limit your options.

“We usually recommend this approach to younger patients with fewer health conditions such as heart disease or diabetes,” says Dr. Kesler, adding that, “Research has shown that men who have low-risk, localized prostate cancer can fare just as well on active surveillance as other men who opt for treatment.”

For more information on treatment for prostate cancer, talk to your primary care physician or click here  for more information about the Tallwood Urology & Kidney Institute.

What's New

Wallingford Endoscopy Center Opens

Endoscopy Center Opens in Wallingford

The Wallingford Endoscopy Center, an 8,533- square-foot space dedicated to gastroenterology procedures, has opened in Wallingford. The center, a joint venture between Hartford HealthCare, Connecticut GI and MidState Gastroenterology Specialists, offers upper endoscopies and colonoscopies in the new facility. “Patients in need of gastrointestinal procedures will find the best care...

What is Inpatient Rehabilitation?

A new inpatient rehabilitation unit opened at Hartford Hospital recently. It’s a 26-bed unit that specializes in physical, occupational and speech therapy for patients who have suffered a major illness or injury. Dr. Maria Tsarouhas of the Hartford Hospital In-Patient Rehabilitation Unit has details on what that means.  Q: This unit opened...

Apple Watch and AFib

Why Heart Patients Shouldn’t Use Apple Watch to Detect AFib

Seems that the Apple smartwatch can do it all – check email, send an SOS, connect to your car, get directions, open your garage door and order a pizza — but checking your heartbeat for atrial fibrillation might not make sense. Dr. Steven Zweibel, director of electrophysiology at the Hartford...

Hartford HealthCare Increases Minimum Hourly Rate to $15

More than 2,400 employees to benefit from increase, effective March 31 Hartford HealthCare today (Monday, 1/14) announced it will increase its minimum hourly rate to $15, effective March 31, 2019. The new pay rate will directly benefit more than 2,400 of Hartford HealthCare’s approximately 20,000 employees throughout Connecticut. These employees...

GoHealth interior.

Hartford HealthCare-GoHealth Urgent Care Center Opens in Torrington

Newly constructed Hartford HealthCare-GoHealth Urgent Care center will replace Charlotte Hungerford Hospital’s former urgent care walk-in center, less than a mile away. GoHealth Urgent Care, one of the country’s largest and fastest-growing urgent care companies, together with its partner Hartford HealthCare, Connecticut’s most comprehensive healthcare network and an affiliate of...

Why Does My Neck Hurt? (It Could Be a Pinched Nerve)

When is neck pain a serious issue? When it’s a pinched nerve, according to Dr. Joel Bauman, chief of neurosurgery at the Connecticut Orthopaedic Institute at MidState Medical Center. Q: What is a pinched nerve? A: A pinched nerve is when there is an injury, usually in the disk, which...

Prostate Cancer Relationships

ED, Incontinence After Prostate Surgery: What Can a Partner Do?

This is the first of a two-part series on the effects of prostate cancer on relationships. Ask any prostate cancer survivor and he’ll tell you there’s no price he wouldn’t pay to be cancer-free. Let’s start with the surest way to cure prostate cancer when the disease hasn’t spread: Removal...