Active Monitoring (Deferred Treatment or Watchful Waiting) in the Treatment of Prostate Cancer

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Abstract
Objectives: To evaluate the concept of active monitoring only in the management of patients with prostate cancer. Methods: Literature review. Results: Active monitoring may be recommended in patients with stage T1a, well– and moderately–differentiated disease. Patients with a life expectancy exceeding 10 years are recommended re–evaluation with PSA, TRUS and biopsies of the residual prostate. This treatment is also indicated in patients with stage T1b–T2b, well– and moderately–differentiated tumours and a life expectancy of less than 10 years. Active monitoring is optional in patients with stage T1b–T2b, Gleason 2–4 prostate cancer and a life expectancy of 10–15 years. It is also optional in asymptomatic patients with locally advanced disease, stage T3–T4 which are well– and moderately–differentiated and have a short life expectancy. A very rare asymptomatic patient with M1 disease and the possibility of close follow–up may be offered active monitoring. Conclusions: Active monitoring is still a viable option for selected patients diagnosed with prostate cancer.

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