Active surveillance for prostate cancer: current status and future directions

PURPOSE OF REVIEW: Active surveillance is gaining traction in treatment of prostate adenocarcinoma (PCa), The most important step in active surveillance is patient selection. This is a comprehensive review of the current active surveillance strategies and features helpful in proper selection of the patients. RECENT FINDINGS: Active surveillance is considered the treatment of choice in low-risk PCa, and new data show its success in management of intermediate-risk PCa. SUMMARY: Active surveillance is a treatment strategy to offer the PSA patients close monitoring by periodic PSA assessments, Digital rectal examination, imaging studies and needle biopsies. When the patient population is accurately selected, treatment by active surveillance is successful, it also avoids overtreatment and reduces treatment-associated comorbidities. Active surveillance is currently considered the treatment of choice for very low-grade and low-grade PCa and is being offered to some favorable intermediate risk PCa. For active surveillance to be successful, there should be a comprehensive surveillance plan, proper use of the clinical diagnostic tests and continuous patient commitment.