Clinically Localized Prostate Cancer – Part II: Principles of Active Surveillance, Principles of Surgery, and Follow-Up
Patient Guideline Summary
- Prostate cancer is the most common non-cutaneous cancer among US men.
- Fortunately, the vast majority of cases are diagnosed when they are clinically localized.
- Early disease has no symptoms. It is diagnosed by physical examination and a blood test for prostate-specific antigen (PSA).
- Note: the risk to your health from prostate cancer varies widely. Therefore, risk determination is an important step in planning treatment.
- The goal of treatment is cure.
- This patient summary focuses on Active Surveillance, Principles of Surgery, and Follow-Up.
- Active surveillance refers to periodic doctor visits with PSA testing, repeat biopsies and multiparametric magnetic resonance imaging (mpMRI).
- If you choose radical prostatectomy, every effort will be made to spare nerves near the prostate. Note: these nerves are responsible for sexual function.
- Removing nearby lymph nodes is done to stage your cancer but is not documented to affect overall outcome. This decision should be made during a discussion of your surgical options.
- The presence of positive nodes (those containing cancer cells) influences subsequent treatment decisions, notably radiation.
- Following surgery, you will be followed for symptoms and PSA tests and encouraged to engage with professional or community support groups.
- ASTRO: American Society For Radiation Oncology
- AUA: American Urologic Association
- MRI: Magnetic Resonance Imaging
- PSA: Prostate-specific Antigen