Putting the ‘Active’ in Active Surveillance

Many men are receiving a diagnosis of prostate cancer that is rated as low-risk or low-volume in terms of it’s likely progression or threat. Almost 50% of the new diagnoses this year in Australia will fall into this category, that’s around 8,000 men who may be offered the choice of deferring treatment by their Urologist.

Surveillance is only half the story….

During the period of deferring treatment the Urologist will recommend regular testing of key prostate disease markers such as Prostate Specific Antigen (PSA), Gleason Score (aggression rating) or imaging of the prostate to detect changes in cancer volume. This is the surveillance component of a management program called Active Surveillance.

These men are initially very relieved to discover that their cancer does not demand immediate surgery, radiation or hormone treatment due to its advanced state or aggressive nature. They leave the Urology office and resume life, work and relationships without the prospect of facing the side-effects of treatment, namely incontinence and erectile dysfunction.

However they often become uneasy when they realise they are now living with an active cancer in their prostate and nobody is recommending treatment (except perhaps for his spouse or children). He may become anxious about the cancer and fret about his future and constantly worry that not treating may not be the best option, despite the evidence from the pathology reports and recommendations from his Urologist. He may feel dis-empowered.

He needs to invest in the Active part of the treatment plan. He needs to educate himself about his prostate gland, cancer and what he can do for himself to slow the progression of any cancer and undermine its development so he never needs treatment. But the Urologist didn’t provide any resources for ‘non-treatment’, just reams of information on incontinence and erectile dysfunction and depression associated with interventional procedures such as surgery, radiation or androgen deprivation therapy (ADT).

Yet there is a huge amount of research and experience demonstrating that men can reduce the progression and development of a low-grade prostate cancer through lifestyle decisions, reducing their stress, physical training and smarter eating habits. The Prostate Playbook is a strategic guide for men and their support team to take some control of their outcome and take action to sabotage their prostate cancer. For these men, the goal is to frustrate the surveillance through smart plays everyday to stay well.

The Prostate Playbook is to be published in May 2019. It will be available in Australia and New Zealand bookstores from June or you can purchase it online after May 15 at this website.