Sunnybrook Health Sciences Centre’s Laurence Klotz, MD, speaks with PCRI about management of low-risk prostate cancer with Active Surveillance. 

What is active surveillance, and how does it compare with other methods of treating prostate cancer?

The concept of conservative management for prostate cancer is not new. In fact, in Scandinavia and England in the 70s, basically no one was treated until they had metastatic disease. And the idea was that treatment....

It seems we have a national passion for prostate biopsies. A million men are biopsied every year. Two hundred thousand of them will be diagnosed with prostate cancer and about half of these with Low-Risk disease, a condition that can be safely monitored without immediate treatment. Even so, more than half of these men with Low-Risk will undergo prompt, radical treatment.  Sadly, irrational fears rooted in the electrifying word “cancer” drive most men into taking immediate action.

Why Screen for Prostate Cancer?

Screening finds earlier stage cancers, allows for simpler treatments with fewer side effects, and saves lives. For example, in 1985, prior to PSA screening, the prostate cancer five-year survival rate was 69% compared to 99% in 2006. It’s unclear whether this dramatic survival increase is entirely due to PSA screening. Other factors, such as improved therapy have also contributed.