Prostate Surgery vs. Active Surveillance

There will be more than 160,000 new cases of prostate cancer – some 26,000 fatalities – this year. There are many different treatments for this disease, but the course you and your physician choose will depend on your cancer, suggested David Canes, MD, an urologic oncologist and surgeon at Lahey Hospital & Medical Center.

Traditionally, the treatment for prostate cancer is surgery or radiation therapy – both of which have shown to be equally effective in erradicating the disease. Still, the decision to treat is a little more complex. “There are two broad buckets of prostate cancer,” Dr. Canes noted. “The more aggressive kind, the lethal kind, is the one we want to treat. The other variety is more dormant and develops with age, but may never cause problems – that’s the kind we want to watch.”

Closely inspecting the cancer cells can give surgeons the information they need to determine the best course of action, Canes explained.

Active surveillance, the treatment strategy of simply monitoring the cancer, was developed as an attempt to curb over treating cancers that are less aggressive. In active surveilance, patients have regular screenings and assessments of cancer growth. This allows physicians to keep a close eye on the development and changes in the aggressiveness or location of the cancer to see what next steps may be required.

“People are surprised when they come see me and I say I don’t think they should have surgery,” said Dr. Canes.

Active surveillance is a dynamic tool for doctors and patients alike, and it’s saving many men the from potential side effects associated with treatments like surgery or radiation. “About two-thirds of men who start on active surveillance never develop any need for further treatment,” Canes said.

Also, because the active surveillance protocol is a living document, it is constantly being tweaked, updated and revised to assure it’s keeping current with new developments in science and screening technology.

“We find that an active surveillance strategy is appropriate for certain prostate cancers,” Canes said. “In some cases, the non-invasive treatment is the best way to go.”

Talk to your Lahey Health physician about prostate cancer care and screenings.


*The content on this website is for informational purposes only and is not medical advice. Please consult a physician regarding your specific medical condition, diagnosis and/or treatment.

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