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Low-Risk Prostate Cancer: Don’t rush to get treatment

If you are diagnosed with low-risk prostate cancer, you should discuss treatments and quality-of-life issues with your cancer care team.

Prostate cancer is often treated by urologists and/or radiation oncologists.

Common treatments are surgery and radiation. However, there is another approach to learn about. It’s called “active surveillance.” It’s for men with low-risk prostate cancer.

In active surveillance, your team watches your condition closely. If tests show that it’s getting worse, you will get treatment. Discuss active surveillance with your team. Here’s why:

Treatment isn’t always needed.

Many men with low-risk prostate cancer are treated immediately, with surgery or radiation. Treatment is not necessary for many patients and it can cause sexual, urinary, and bowel problems.

Often, prostate cancer is low-risk.

Many prostate cancers are found with a prostate-specific antigen (PSA) blood test. Often these cancers are low-risk. This means:

For most men with low-risk prostate cancer, the tumour is probably growing so slowly that it will not become life-threatening. Usually a man with low-risk prostate cancer passes away of something else, even if he doesn’t get treatment for prostate cancer.

Active surveillance may help your quality of life.

With this approach, you have regular checkups, including a PSA test and rectal exam. You’ll get a prostate biopsy if needed. You can start treatment at any time if the cancer starts to grow.

Active surveillance is a good choice for many men with low-risk prostate cancer, because they can avoid the side effects of treatment. This is an especially important choice if you are older or in poor health.

Treatment can have side effects.

Side effects from surgery or radiation may include:

When should you get immediate treatment for prostate cancer?

If your cancer is advanced or higher-risk, you will probably need treatment right away. Signs of higher-risk cancer include:

Ask your team if your cancer shows any of these signs. If so, active surveillance may not be a good choice.

Talk to your cancer (oncology) care team.

Your team is an important source of advice. Some men may benefit from having a low-risk tumour treated right away, even if they might have side effects. Discuss your treatment options and quality-of-life issues with your team.


Choosing a treatment for prostate cancer:

Most men with low-risk prostate cancer have time to think about their choices. These tips may help you reach a decision.

Review your health history. Give your cancer care team your full personal and family medical histories. Ask how your age and general health could affect treatment. Ask if you have any condition that might increase the risks of treatment, for example, conditions such as diabetes, heart problems, or bowel disease might increase your risk of sexual, urinary, or bowel problems.

Think about your values. Discuss these questions with your spouse or partner:

Find out all of your treatment options. Ask your doctors about each choice, including benefits and side effects. Some doctors only suggest the option they know best. Typically:

Talk about your choices with these physicians and your family doctor.