Active surveillance involves the careful monitoring of prostate cancer progression in patients with less aggressive tumours. An increasing proportion of patients with Gleason 6 cancers, particularly in the older age group, are having their tumours monitored.
Monitoring involves four-monthly prostate specific antigen (PSA) testing, a repeat biopsy every 12 to18 months and then ongoing monitoring depending upon these results.
This management option has become increasingly popular following the realisation that many patients with prostate cancer, particularly older patients with low-grade cancer, die with the disease rather than because of it. In appropriately selected patients, this is a safe management option, with about one in three patients ultimately requiring treatment within 10 years.
Personally, I have over 500 patients on active surveillance.