In the active surveillance approach, the physician closely monitors the course of the patient's disease over time and initiates treatment when test results demonstrate disease progression.
Active surveillance is not synonymous with watchful waiting. Although the watchful-waiting approach also consists of patient monitoring, physician follow-up, observation, and testing are less intensive than in the surveillance approach. Moreover, in the watchful-waiting approach, patients who experience local or metastatic disease progression receive palliative treatment on the basis of their symptoms.
The watchful-waiting approach is typically reserved for patients of advanced age (> 75 years old); patients with significant, life-limiting comorbidities; or patients who have a life expectancy of < 10 years. In such patients, the risks associated with treatment outweigh the benefits—ie, most patients will probably experience worse quality of life if their cancer is treated than if they had waited for disease progression. These patients have a very high chance of dying from another cause, and prostate cancer treatment could worsen comorbid (eg, cardiac) disease and hasten death.
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Any views expressed above are the author's own and do not necessarily reflect the views of WebMD or Medscape.
Cite this: Bradley Schwartz. Fast Five Quiz: How Much Do You Know About Prostate Cancer Treatment? - Medscape - Apr 04, 2019.