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Managing Prostate Cancer May Mean Waiting

Research shows that for some patients who have prostate cancer, moving immediately to treatment may not be in their best interest.

Under a doctor’s guidance, sometimes the best choice for managing prostate cancer may be closely monitoring the condition instead of rushing into treatment — an option known as active surveillance or watchful waiting.

“In some men who have early-stage prostate cancer, the disease may never progress to a point where it causes problems or truly requires treatment,” says Anwar Khurshid, M.D., an oncologist with Arlington Cancer Center, a Texas Health Physicians Group practice, and on the medical staff at Texas Health Arlington Memorial Hospital. “For others, treatment options may not be appropriate due to their medical condition. In both of these situations, closely tracking the progress of the disease may allow us to avoid unnecessary treatment and the complications that sometimes occur alongside treatment.”

Dr. Khurshid is referring to the rare but serious complications that sometimes accompany procedures such as biopsies, as well as the possible risks to fertility, continence and other areas of wellness that can accompany treatment for prostate cancer.

When Watchful Waiting Is Right

It is a doctor’s job to help patients weigh the pros and cons of each prostate cancer management plan using that case’s unique details. Watchful waiting and active surveillance are medical protocols that involve routine follow-ups with a healthcare team to monitor disease progression.

To qualify for these approaches, patients typically must be low risk, meaning they have:

  • Early-stage cancer that has not spread beyond the prostate
  • Cancer that is found only in one half of one lobe of the prostate
  • Prostate cancer grading scores on the Gleason scale of less than six
  • Prostate-specific antigen (PSA) reading of 10 or less
  • Willingness to follow up regularly with a doctor

How It Works

Initially, patients on active surveillance meet with doctors every three months for PSA screenings and have biopsies done once a year. Those follow-ups may increase or decrease depending on the findings, and other diagnostic tests such as ultrasounds may be necessary during the process.

“Active surveillance is appropriate only for patients who are motivated to continue routine follow-ups,” Dr. Khurshid says. “If we do find disease progression, that signals us that it is time to move on to treatment, whether that means surgery, radiation or a combination of both. The goal is to do whatever is best for the patient while at the same time minimizing the negative impact of the disease on his life.”

Find a Texas Health Physicians Group doctor who can help you manage prostate health.

Physicians employed by Texas Health Physicians Group practice independently and are not employees of the hospital or Texas Health Resources.

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