active surveillance or prostate cancer

Indications

• prostate cancer with favorable prognosis
  • T1c, PSA density <0.15 ng/mL, Gleason score <=6, <=2 positive biopsy cores, & <=50% of a core involved
  • <=T2a, PSA <10 ng/mL, & Gleason score <=6

Procedure

• a structured, prospective management approach
• monitoring with serial
  • prostate-specific antigen (PSA) testing
  • digital rectal examination (DRE)
  • prostate biopsies

Notes

• it is not clear how much better this is than observation & how much of this is necessary for full benefit, i.e. serum PSA alone every 6 months or annually
• it is not clear why a digital rectal examination adds much when a prostate biopsy will be done regardless
• finanicial incentives for urologist to biopsy patients with low-risk prostate cancer is not discussed

More general terms

• cancer management