Active Surveillance for Prostate Cancer

Keyan Salari, MD, PhD, is the director of the High-risk Prostate Cancer Clinic within the Massachusetts General Hospital Department of Urology, and a urologic oncologist with the Mass General Cancer Center. In this video, he discusses his team's work to identify the features of seemingly indolent prostate cancers that actually make them more aggressive.

Advances in Motion provides health care professionals with information about the latest breakthroughs, research and clinical advances from Massachusetts General Hospital.

[robertmonroe]

If the father had indolent or very low risk prostate cancer and died of unrelated causes at age 87, does that mean the son who is diagnosed with very low risk cancer at age 60 will likely have a similar trajectory of disease?

As opposed to the 60 year old who is diagnosed and doesn’t think his father ever was diagnosed with prostate cancer. (And, of course, really has no idea if his father actually had undiagnosed and indolent prostate cancer).

The vague term ‘family history of prostate cancer’ needs to be refined.

We are most concerned with aggressive prostate cancer.

[podge]

Is active surveillance an option for someone diagnosed under 50 years old

[scottjackson]

My biggest issue with Active Surveillance is the need for ongoing biopsies. Nothing about a transrectal biopsy should be regarded as routine. Absent medical intervention (prostate removal or radiation), a man’s PSA score will not go down. It seems to me that, for any Gleason 7 or above, the patient should wait no longer to get treatment.