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Active surveillance for men with low-risk, clinically localized prostate cancer

Author
Laurence Klotz, MD
Section Editors
Nicholas Vogelzang, MD
W Robert Lee, MD, MS, MEd
Jerome P Richie, MD, FACS
Deputy Editor
Michael E Ross, MD

INTRODUCTION AND DEFINITION OF TERMS

Active surveillance for men with prostate cancer involves the avoidance or postponement of immediate therapy combined with careful surveillance; definitive treatment is then offered if there is evidence that the patient is at increased risk for disease progression. Active surveillance is the preferred option for the initial management of most men with localized low-risk prostate cancer [1,2].

Active surveillance differs from watchful waiting (observation), which is based upon the premise that men will not benefit from definitive treatment of clinically localized prostate cancer because of limited life expectancy, comorbidity, and the prolonged natural history of the prostate cancer [3]. For patients managed with watchful waiting, the decision is made at the outset to forego definitive treatment and to provide systemic or local treatment to palliate symptoms if disease progresses locally or at distant metastatic sites.

Key aspects of active surveillance for patients with localized low-risk prostate cancer will be reviewed here, including:

Rationale

Criteria for patient selection

                 

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Literature review current through: Mar 2017. | This topic last updated: Nov 28, 2016.
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