Most men with low-risk prostate cancer select lively surveillance over immediate treatment with radiation, hormonal therapy, or surgery. With lively surveillance, men monitor their cancer and don't treat it until it gets worse.
Going by the numbers
In general, lively surveillance is an option for men with low-grade cancer (cancer confined to the prostate gland and fewer more likely to spread), that's, those with a prostate-specific antigen (PSA) level of 10 nanograms per milliliter. (ng/ml) is lower than ) and a Gleason rating of 6 or less. Advanced and lots of intermediate-grade prostate cancers don't qualify for lively surveillance, and treatment is often began immediately.
Another group who aren't good candidates for lively surveillance are men with a family history of malignant prostate cancer and people with BRCA gene mutations, particularly BRCA2, that are related to prostate cancer. Associated with high risk.
The blood test measures PSA, a protein produced by each cancerous and non-cancerous tissue within the prostate. The Gleason system involves grading the 2 commonest kinds of cancer cells in male biopsy tissue on a 5-point scale. The two classifications are combined to acquire a Gleason rating, with 10 being the very best. The higher the number, the more likely the cancer will grow and spread.
Active surveillance men have periodic PSA tests and digital rectal exams, wherein the doctor feels for abnormal areas on the prostate. These are often scheduled every six months.
A repeat biopsy is completed one yr after the initial diagnosis after which three years after that. Further biopsies are done on the direction of the patient and his doctor. Your doctor might also order a prostate MRI in the course of the monitoring phase.
“In general, the higher a man's PSA level, the more likely he is to develop prostate cancer,” says Dr. McGovern. “Also, a significant increase in PSA levels over a year can be a sign of cancer.”
If the PSA level rises or a brand new or growing growth is detected during a rectal exam, your doctor will likely recommend a prostate biopsy sooner than the standard protocol to find out if the prostate is healthy. Whether the cancer has turn out to be more aggressive.
“If the biopsy doesn't show any changes, you and your doctor may decide to continue with active surveillance, but if it does, or your prostate size increases or your Gleason If the score is high, your doctor may suggest going ahead with surgery, radiation, or hormonal therapy,” says Dr. McGovern.
Action steps
As with any medical procedure, lively surveillance has its risks. “The most serious of these is underestimating the development of cancer until it becomes life-threatening, even though this happens in a very small percentage of men,” says Dr. McGovern.
Another drawback is psychological – the constant worry, stress and anxiety that could make cancer worse since you're not getting treatment. One method to overcome these feelings is to take responsibility on your health.
Dr. McGovern says, “Instead of waiting to see if their prostate cancer gets worse, men can take steps to improve their cancer situation and even reduce the risk of other health problems, such as heart attack and stroke.” Can also prevent stroke.” “It can empower men and provides them a greater sense of control over their condition.”
He offers these suggestions:
Increase exercise intensity. A study published on August 19, 2021 JAMA Oncology found that lively surveillance men reduced their PSA levels and cancer cell growth after doing half-hour of high-intensity interval training (HIIT) on a treadmill 3 times per week for 12 weeks. In HIIT, you alternate between intense aerobic output and periods of rest. In this study, men repeated a pattern of two minutes of HIIT followed by two minutes of recovery.
Another study found that men with prostate cancer who engaged in additional frequent vigorous activity had a 30 percent lower risk of developing the cancer and a 30 percent lower risk of developing malignant cancer than men who exercised less. 25 percent less. Examples of vigorous activities include running, cycling, swimming, and racquet sports. (Be sure to ascertain along with your doctor before starting any form of exercise program.)
Watch your cholesterol. Studies have shown that men who take cholesterol-lowering statins have a lower risk of prostate cancer. Statin use can also be related to longer survival in men with prostate cancer. “Get your cholesterol levels checked, and if they're high, talk to your doctor about whether to take statins,” says Dr. McGovern.
Manage your weight. Weight gain is related to more aggressive cancers. “Losing five to 10 extra pounds can also help lower your risk,” says Dr. McGovern. A healthy weight also keeps blood pressure and levels of cholesterol under control.
Eat a plant-based weight loss program. While it's unclear whether specific dietary habits can influence the event of prostate cancer, Dr. McGovern has found that his patients do significantly better once they follow a plant-based weight loss program just like the Mediterranean or MIND weight loss program. are higher. He recommends consulting a nutritionist who can offer guidance on meal planning.
Consider therapy. Your concern about lively surveillance could also be related to something else. “A therapist can help you discover where your anxiety is and what might be causing it,” says Dr. McGovern. “Resolving any issues may help to alleviate your uncertainty or reluctance about active surveillance.”
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