Widespread screening with PSA and DRE leads to the detection of prostate cancer at an early stage. However, a significant number of prostate cancers diagnosed are slow to develop and do not pose a threat to a man’s longevity. Once diagnosed with prostate cancer, at UCLA we use information such as your PSA, Gleason grade, MRI findings and biomarkers to determine the overall risk of your cancer spreading. If you have low risk prostate cancer (low PSA, small amount and low Gleason score), we know that you are not likely to die of prostate cancer. As a result, we will often not recommend treatment for these cancers.
For patients with slow-growing tumors, UCLA offers the option of Active Surveillance for cancer of the prostate. Active Surveillance is a structured program of monitoring for men who, because they are deemed at little cancer risk, choose to defer surgery or radiation therapy, hopefully for the duration of their lives. At UCLA, we have established an active monitoring program that includes the use of periodic PSA, DRE, MRI and repeat biopsy. This allows us to ensure the cancer is not progressing and does not need treatment. We strongly believe active surveillance is important for men with low-risk tumors in order to avoid the side effects of treatment. For those men who do require treatment, evidence shows that they are still able to be effectively treated even after being on active surveillance for several years.
For some men depending on their age, cancer characteristics and family history, we will recommend treatment. This is often a very personalized decision made between provider and patient. Both surgery and various forms of radiation can be used to treat low risk prostate cancer.