active survallance

Hi mach . Active surveillance is a term I've come across in several times, that or "watchful waiting".

My husband was put on it when he first had a blood test (PSA) in 2011 - he did not have any symptoms, he'd been to his GP about lower back pain which apparently can be a symptom of Prostate cancer.

He had six monthly blood tests and it gradually went up from 5.6 to 11 (about 2 years later) at which point he was referred for biospsies and MRI scan. His prostate cancer was found to be localised, he had hormone injections, brachytherapy and three weeks of external beam radiotherapy.

6 months late his PSA was 0.5. He was discharged back to his GP from his Oncologist after 5 years in 2018 and still has 6 monthly PSA tests, the last was 0.19.

So my hubby was on active surveillance for 2 years, it's not quite as frightening as it seems.

Hope the other members here pop along to share experiences.

Sending, Hugs, B xx

Both my brother and I have prostrate cancer. My brother has been on active surveillance for over five years. He takes medication to reduce the size of his prostrate combined with blood tests every six months and biospsies every year, (were they take six samples).Like most things it is something you get use to. The good thing about survallance is that you are your in the system which should give you some comfort.

thankyou for that and much appreciated  hope every thiing is well with you regards peter

thankyou for your time and assurance 

So long as it is "active" that is you take notice of any changes yourself and flag them up to your Doc and have regular PSA tests at least every 6 months - going down to 3 monthly if there is a rise in PSA and an MpMRI and biopsy  once a year.  That way any changes can be seen and acted on quickly when it is to all intents and purposes "curable".

Hello Mach,

I was on 'active surveillance' for nine years. During that time I received regular hospital checks (DRE Digital Rectal Examination - unpleasant to start with but I got used to it), PSA blood tests and  later in the 9 years an MRI or two. My PSA doubled from 8 to 16 in that time which is a slow doubling time. I'm now starting hormone therapy prior to radiotherapy since the tumour has grown, but I'm 75. I expect to live to 95!

All I would say is that you need to get your oncologist to monitor it for ANY changes and watch out for a rapid doubling time of PSA which indicates tumour  activity (although PSA on its own is not an indication of how severe a cancer might be). If this happens then I suggest that you look at your treatment options, preferably before it gets to the T2 stage.

You may go through many years on active surveillance without much happening and you may get to be very old before anything happens but it is wise to know what is happening and choose a stage where you might seek out treatment, if needed.

Oh, one other thing. try to get a female oncologist to do your DRE, they are much gentler than the male ones in my experience!

Good luck, I wish you well.

I agree with what others have said: it's fine, so long as it's well managed.

The curative treatment options for PCa are all pretty horrendous, and it's a generally slow cancer, so there is logic for some people in delaying active intervention. For example, for very young men, and also for very old men (who may never need intervention at all).

But the nightmare scenario is postponing active treatment for too long, and finding that the cancer has spread, and cure is not an option.

So active surveillance needs to be set up right: you need to know exactly what PSA level will ring the alarm bell, you need to have whatever scans / biopsies are agreed, at the times and frequencies that were agreed. And you need to know who is in charge; you / GP / urologist. Unless you have good professionals that you trust, then don't even think about it..

Active surveillance is best with low stats so ,  Gleeson pref 6/7 which would hopefully be showing non aggressive.

PSA low, pref in single figures with no large increases between tests .

Tumour confined to the gland and not near the capsule edge.

As others have already said, keeping on top of it in terms of regular testing.

Steve

Absolutely Steve.  If possible have an mp MRI scan regularly too or even an ordinary MRI as it will show where the tumour is and if it is pushing on the outside of the prostate which could mean cancer cells have escaped or are likely to escape.  My oncologist - when I got to see him with a PSA of nearly 13 said he wished he had seen me when it was at 9 as looking at biopsies and scans then would probably have meant I could have had brachytherapy but when I got there with the higher PSA the tumour was pressing on the edge of the capsule and could have escaped.  Having said that that was 5 years ago and 9 months of Hormone Therapy and a month of radiotherapy seem to have cured this disease for me - but you never feel safe again.  My brother got his diagnosis at the age I was when my PSA was around 9and had a lower PSA,  had brachytherapy a few years after me and thankfully both of us are fine at the moment.  Neither of us had rapidly doubling PSA just a very steady rise over the for a year or so.

hope  everything OK with yourself Des

Steve