E. David Crawford, MD, from the University of Colorado, Anschutz Medical Campus, discusses active surveillance as a treatment approach for men with prostate cancer.
E. David Crawford, MD, professor in Surgery and Radiation Oncology and the head of Urologic Oncology at the University of Colorado, Anschutz Medical Campus, discusses active surveillance as a treatment approach for men with prostate cancer.
To frame the current state of active surveillance, Crawford notes that previous PSA screening methods resulted in overdiagnosis and overtreatment. However, he does not believe that PSA screening should be completely discontinued. When a patient is diagnosed by PSA they should not immediately be rushed to an operating room or receive radiation therapy, Crawford points. Instead, their PSA level should be used more intelligently and active surveillance should be considered.
Identifying the most optimal patients for active surveillance is one of the most challenging aspects of the approach. In general, Crawford notes, these patients have low-grade prostate cancer, very few cores, their PSA levels are not very high, and they are motivated to undergo the procedures involved in active surveillance, which includes consistent biopsies and testing.