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What is active surveillance when diagnosed with prostate cancer, and when is it appropriate?

Some types of prostate cancer are diagnosed in advance of being clinically relevant. This happens because the cancer is slow growing or because the man has other health concerns that should be prioritized. Active surveillance is an approach that avoids the harms of over-treatment while still preserving the option to going forward.

Men on active surveillance are monitored with blood tests, urinary biomarkers, imaging, and repeat biopsy if necessary. If the cancer becomes clinically relevant – which happens in about a third of cases – the patient may choose to pivot to formal treatment.

Hoag now offers a “middle ground” option for patients with localized prostate cancer that hasn’t spread. but who may prefer a more proactive approach than active surveillance. For these patients, a High Intensity Focused Ultrasound ablates the cancerous prostate tissue without damaging the healthy surrounding tissue. Benefits include a low risk of side effects with minimal downtime. If you have been told you have localized prostate cancer and would prefer to treat it, talk to your urologist to see if HIFU might be a good option for you.

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By Jeffrey C. Bassett, M.D., M.P.H.