How does active surveillance or expectant management of early-stage prostate cancer work?
“We super-select people who have low-risk disease for our active surveillance program” explains H. Ballentine Carter, MD. Carter is professor of urology at Johns Hopkins Medical School in Baltimore. He is also director of adult oncology at the James Buchanan Brady Urological Institute at Johns Hopkins. Currently about half of all men diagnosed with prostate cancer will have low-risk disease at the time of diagnosis, Carter tells WebMD. This is based on several different criteria, including: • A prostate-specific antigen (PSA) level of less than 10 • A Gleason (tumor aggressiveness scale) score of 6 or less on a scale of 2-10 • Stage T1c disease, meaning that the tumor cannot be felt on digital rectal exam and is detected only on needle biopsy, or • Stage T2a disease, meaning minimal detectable disease in one half lobe of the prostate or less “We select people from that group of individuals,” Carter says. “And we recognize that some of them are going to have a disease that could be pote