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Active Surveillance for Prostate Cancer: A Review

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Abstract

Active surveillance is a solution to the widely acknowledged problem of overdiagnosis and overtreatment of clinically insignificant disease which accompanies early detection of prostate cancer using prostate-specific antigen (PSA) and biopsy. It is an approach to the management of favorable-risk prostate cancer which uses the opportunity provided by the long natural history of the disease to incorporate a period of initial observation into patient management. The basic concept is that most men diagnosed with low-grade, small-volume disease are not destined to have any clinical manifestations of the condition during their lifetime. However, a subset of patients with favorable-risk prostate cancer is at risk, due to either the presence of higher-risk disease not apparent at diagnosis or progression to a more aggressive phenotype over time. These patients can be identified with reasonable accuracy by close follow-up, including serial PSAs and biopsies, and treated effectively in most cases. The rationale, patient selection, method of follow-up, triggers for intervention, and recent results of this approach will be reviewed.

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Authors and Affiliations

  1. Division of Urology, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, #MG408, Toronto, ON, M4N 3M5, Canada

    Laurence Klotz

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  1. Laurence Klotz
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Correspondence to Laurence Klotz.

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Klotz, L. Active Surveillance for Prostate Cancer: A Review. Curr Urol Rep 11, 165–171 (2010). https://doi.org/10.1007/s11934-010-0110-z

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