Active surveillance for prostate cancer: past, present and future

Area of Science:

• Urology
• Oncology
• Medical Research

Background:

• Localized prostate cancer management presents challenges for urologic oncologists.
• Prostate-specific antigen screening increases detection of low-risk prostate cancers.
• Radical treatments (surgery, radiation) carry significant side effects like incontinence and erectile dysfunction.

Purpose of the Study:

• To review recent advancements in active surveillance for localized prostate cancer.
• To discuss the role of active surveillance in managing low and intermediate-risk prostate cancer.
• To highlight the potential of active surveillance to improve quality of life.

Main Methods:

• Literature review of recent developments in active surveillance for prostate cancer.
• Analysis of current challenges and benefits of active surveillance strategies.
• Synthesis of findings regarding patient selection, monitoring, and treatment triggers.

Main Results:

• Active surveillance aims to mitigate or postpone adverse events from prostate cancer treatments.
• It allows for future curative intervention if the cancer progresses.
• This approach is suitable for many men with low-risk and some with intermediate-risk prostate cancer.

Conclusions:

• Active surveillance is a practical treatment choice for suitable prostate cancer patients.
• Optimal criteria, monitoring, and treatment triggers for active surveillance require further investigation.
• Advances in imaging, biomarkers, and focal therapy may enhance active surveillance adoption and outcomes.