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The least intrusive treatment is actually no treatment at all and thereby offers the best quality of life. It is called Active Surveillance.

Though parameters might differ slightly depending upon the medical center or physician, it is generally appropriate for men whose PSA (Prostate Specific Antigen) is equal to or less than 10 and whose Gleasen Score (Tumor Grade) is equal to or less than 6.

It is meant for men who have a low grade cancer, a 15 year life expectancy, and a tumor stage less than T2a.

The purpose of active surveillance is to carefully and closely monitor the cancer but provide no treatment unless the cancer becomes more aggressive (Active Surveillance would no longer be appropriate for example if your PSA doubles in less than 3 years or your Gleason score is > 7).

Follow ups might include PSA and DRE’s every 3 months for two years and then, provided the PSA doesn’t rise, every 6 months after that with a biopsy involving 10-12 core samples in one year and then every 3 years til age 80 but this can vary somewhat. Many medical centers or physicians ask that a contract be signed in which you agree to follow these protocols.

Clearly Active Surveillance is meant for men who have a low-risk tumor and can make themselves comfortable with the idea that though cancer is present it is not currently a danger to them and it certainly affords a high quality of life. Recent studies focused mostly on the satisfaction of older men but “did not look at treatment outcomes in younger men or those at high risk, such as African American men and those with a family history of the disease.” More research needs to be done.

 

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