Prostate Cancer and Active Surveillance - Mount Sinai Medical Center
Prostate Cancer

Prostate Cancer and Active Surveillance

The prostate is a male gland which is one component of the reproductive system, and is located near the urethra and bladder. It is responsible for generating some of the fluid in semen, which makes it essential to the reproductive process.

The American Cancer Society estimates that nearly 200,000 men develop prostate cancer each year, and that of these, roughly 10% will die as a result. Prostate cancer has become the second leading cause of cancer deaths among males (behind skin cancer), and its early identification is crucial to the formulation of a treatment plan which can avoid a worst-case scenario.

How do I know if I’m a candidate? 

It is not known exactly how prostate cancer develops in males, although it is recognized that persons who have a father or brother who have contracted prostate cancer are more at risk for contracting it themselves. Also, African-American or Jamaican males are more likely to develop prostate cancer than other ethnic groups, although the reason for this is likewise unknown. Generally speaking, prostate cancer is far more common in North America and Europe than in continents such as Africa and Asia, and it is thought that diet and lifestyle may be a contributing factor, but science has not yet proven that.

Age is another risk factor for developing prostate cancer, with more than 60% of all cases occurring in men over the age of 65 – by contrast, there are very few cases of prostate cancer which occur in men aged 40 or below. Diet seems to play a role in higher incidence of prostate cancer as well, with more cases occurring in males who eat more fatty foods and red meats, while eating less fruits and vegetables. Obese men also seem to be more likely to contract the disease, although once again the precise reasons for this are not yet known.

What kind of treatments is available? 

The treatment options considered for prostate cancer are very often associated with the stage and grade of the cancer, as well as a person’s age at the time of diagnosis. Other serious health conditions that a person might have would also need to be taken into account, and even the likelihood that treatment will eventually cure the cancer should be considered.

One of the treatment options for prostate cancer is watchful waiting or active surveillance, because in some cases a patient might opt to receive no formal treatment at all, especially if the patient is an older male. During active surveillance, a doctor will monitor the development of cancer by taking blood tests, rectal exams and tissue biopsies. Other than those procedures, both patient and doctor simply observe any changes in symptoms to decide on whether more formalized treatment is necessary.

When more drastic measures are needed, surgery to remove the cancer is an option, as is chemotherapy, radiation therapy, and cryotherapy. Vaccine treatments can be effective in some cases and bone-directed treatments can also be used, depending on the stage of the cancer, and the expected lifespan of the patient.

Can prostate cancer worsen? 

Oddly enough, surveys make it clear that nearly 70% of all males with prostate cancer simply ignore the symptoms, choosing instead to live with the symptoms which should make it obvious something is wrong. These symptoms can include difficulty climbing stairs, loss of sleep, a burning sensation during ejaculation or urination, and a loss of bladder control.

While these symptoms do impact lifestyle, a great many men still choose not to seek treatment. However, the prostate cancer can escalate into something worse, when spread of the tumor takes place. Metastasis is the spreading of cancer from its original location to other parts of the body, and once this begins happening, symptoms will inevitably worsen and as the disease progresses, a worse outcome becomes more likely.

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