Being diagnosed with prostate cancer is a life-changing moment. You may feel shocked and overwhelmed, and possibly confused by the various treatment options.
But it’s important to know that survival rates for prostate cancer are high and improving, and not all cases of prostate cancer behave in the same way.
For some men, the cancer grows slowly so it isn’t an immediate threat. While for others it might be aggressive and need urgent treatment.
If you have low-risk, localised prostate cancer without any major symptoms or problems, your clinician may monitor the cancer through active surveillance.
This article explains active surveillance as a prostate cancer management option. It also explains how PSA (prostate specific antigen) tests are used to monitor your condition while under surveillance.
Understanding your diagnosis, as well as the various treatment options and their side effects, will help you make an informed decision in consultation with your GP and/or urologist.
This information isn’t a substitute for medical advice, so please consult your GP or urologist about your personal circumstances.#ActiveSurveillance may be recommended for low-risk #prostate cancer. Find out how #PSAtests are used to monitor your condition. #menshealth Click To Tweet
Grades and stages of prostate cancer
After non-melanoma skin cancer, prostate cancer is the most common cancer in Australia. In fact, more Australian men die of prostate cancer each year than women do of breast cancer. Fortunately, advances in cancer detection and PSA blood testing have led to a lower incidence of aggressive tumours.
Prostate cancer is unusual because it can grow slowly in some men without becoming a major threat. This means treatment options depend on the grade and stage of the cancer.
The cancer grade indicates how quickly the cancer is growing. The Gleason scoring system determines how different the cancerous tissue is to normal tissue. The higher the Gleason score, the more aggressive the cancer and the more likely it is to spread to other areas.
The cancer stage describes the size of the cancer and how far it has spread within or beyond the prostate. The cancer stage may be described as:
- Localised – the cancer is only within the prostate gland
- Locally advanced – the cancer is larger and has spread outside the prostate to nearby tissues and/or organs
- Metastatic – the cancer has spread to distant parts of the body, such as the lymph glands or bones.
What is active surveillance?
For men who’ve been diagnosed with localised prostate cancer, the risk of the cancer progressing may be categorised as low, intermediate or high.
This risk is decided by factors such as:
- the grade of the cancer
- your pre-biopsy PSA level
- your overall health and age
This risk can then be used to work out the best course of management or treatment.
Although modern treatments are improving the cure rates for prostate cancer, the side effects of these treatments can affect men’s quality of life, including sexual function and continence.
Active surveillance is a way to monitor localised prostate cancer that’s considered low risk (or in some cases intermediate risk). USANZ UroOncology Advisory Group Leader Professor Shomik Sengupta says surveillance helps to avoid over-treatment and treatment-related side-effects.
It usually involves regular PSA blood tests (every three to six months), rectal examinations, MRI scans, and biopsies at a frequency your urologist will discuss.
These tests and checks monitor changes in the cancer’s size and behaviour. If changes are found and the condition gets worse, your urologist may recommend treatments such as radiation therapy or surgery.#ActiveSurveillance is a way to monitor prostate cancer that's considered low risk. #menshealth #prostate #PSAtest Click To Tweet
Regular PSA testing as part of surveillanceThe #PSAtest remains the best early detection tool for #prostate cancer #ActiveSurveillance #menshealth Click To Tweet
Predicting how prostate cancer might behave is based on information from PSA tests, physical examinations, scans and biopsies, says Professor Sengupta.
Clinical guidelines have been developed for the appropriate use of PSA-testing for active surveillance patients. You should always follow your urologist’s recommendation on the frequency of PSA-testing.
Surveillance of low-risk #prostate cancers can help to avoid over-treatment and treatment-related side effects. #PSAtest Click To Tweet
“If a man is diagnosed with prostate cancer, it’s important that treatment decisions are tailored individually. Most importantly, low-risk prostate cancers should be increasingly kept under active surveillance, thereby delaying, or perhaps even altogether avoiding, treatment and related side effects.”
Professor Shomik Sengupta, The Conversation
Monitor your prostate health from home
If you’re on an active surveillance program, in consultation with your clinician, there is an alternative way to get a PSA test. MyHealthTest offers an easy at-home option to check your prostate health and can send you a simple fingerprick PSA test in the post.
This fingerprick blood test involves placing a few spots of blood from your fingertip onto a special collection card, which is then posted back to our Canberra pathology lab. We send you the results via a secure website, and you can share and discuss these results with your doctor as you choose.
If your PSA levels are outside the expected range, we’ll let you know and recommend following it up with your doctor. You can also track your results over time on our secure website.
For more information about active surveillance for prostate cancer, please talk to your doctor. You can also access more resources from Cancer Council Australia and the Prostate Cancer Foundation of Australia.
Blogs on related topics:
- Understanding prostate health: what is a PSA level?
- Five top health checks for men over 50
- How accurate is a fingerprick blood test?