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Where are all the people on Active Surveillance (AS)?
Prostate Cancer | Last Active: Oct 26, 2025 | Replies (59)Comment receiving replies
Well, it works until it does not, obviously.
That is what @rlpostrp was trying to say. It works for couple of years but the result is the same- in couple of years cancer becomes more advanced and treatment is necessary in the vast majority of cases. With that logic my husbands AS was successful since he was on AS for 7 years, actually longer since his first MRI was even before that, and PSA was checked for 10 years. His PSA was only 7.6 when his 4+3 was discovered, and that lesion shrunk in size BTW. After biopsy his PSA fell to 5.2 !!! ONLY after his gland was taken out it was obvious that is was taken in the last second (and maybe not).
I can talk only from my own experience and what I read here on this forum, our case is far form being exception here, unfortunately.
The younger the patient, the more troubling "waiting" is since 50 year old has 30 years ahead of him, unlike somebody who is 70.
It all has to be taken into account when making a decision.
Replies to "@jeffmarc Well, it works until it does not, obviously. That is what @rlpostrp was trying to..."
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@surftohealth88
“It (AS) works for couple of years but the result is the same - in couple of years cancer becomes more advanced and treatment is necessary in the vast majority of cases.”
Not to be argumentative, but a recent (2024) Canary Prostate Active Surveillance Study (CanaryPASS), which collected data and tissue samples from more than 2,300 patients with early-stage prostate cancer found;
“10 years after diagnosis, that 49% of men using active surveillance…remained free of treatment or progression and < 2% developed metastatic disease and < 1% died of prostate cancer.
Further, patients who were treated after several years of active surveillance had the same rates of poor outcomes, such as adverse pathology or metastasis, as those treated immediately following a confirmatory biopsy, validating active surveillance as a safe initial management strategy for low-risk prostate cancers.”
https://www.fredhutch.org/en/news/releases/2024/05/active-surveillance-shown-to-be-an-effective-management-strategy.html
If AS results were not so promising the NCCN would not be indicating that AS is the PREFERRED treatment for those diagnosed with GG1 and a viable option for those with GG2.
I try to be careful NOT to say that other men with GG1 or GG2 should implement the ERASE exercise protocol to see a 25% reduction in their PSA, 12 month follow up mpMRI lesion reversal and VO2 Max increases of 25% after two years of implementing the ERASE protocol; even though that is what happened in my case. I know that my experience may not be normative…
I’m sure we can agree that every man diagnosed PCa needs to do as much research as they can tolerate and then make a treatment/AS decision, in consultation with their trusted physician, that is suitable for them.
A decision for Active Treatment or Active Surveillance will be different, based on a patient priorities, even in cases where the clinical/genomic data is nearly identical…and so it should be because of the nature of this disease.