HJAR Sep/Oct 2023

60 SEP / OCT 2023 I  HEALTHCARE JOURNAL OF ARKANSAS DIALOGUE COLUMN UROLOGY WITH today’s advanced testing and imaging, many low-risk prostate cancer patients can safely avoid multiple biopsies and invasive treatments in favor of active surveillance. There was a time when any cancer- positive prostate biopsy was seen as a red alert moment, which usually moved quickly to invasive, often life-changing treatments like surgery and radiation therapy. Through careful study and medical ad- vancement, however, we came to more fully understand the nature of prostate cancer and how it spreads. In the process, we’ve developed powerful tools that can help us predict to a high degree of certainty which prostate cancers will be slow-growing and which should be aggressively treated right out of the gate. To fully confirm or rule out a prostate can- cer diagnosis, most patients with abnormal Get Active NEWTOOLS MAKE ACTIVE SURVEILLANCE A GOOD OPTION FOR MANYWITH LOW-RISK PROSTATE CANCER digital rectal exam and elevated prostate- specific antigen (PSA) levels will need at least one prostate biopsy. Some will require tra- ditional treatment with surgery or radiation. But for men with biopsy-confirmed prostate cancer that is considered clinically insignifi- cant and low risk, today’s next-generation testing and imaging can make active sur- veillance a safe option, helping more pa- tients avoid multiple biopsies, surgery, and radiation therapy. Our experience at Arkansas Urology has been that half of newly diagnosed prostate cancer patients can safely avoid traditional treatment in favor of active surveillance that utilizes these tools. Why choose active surveillance? The available therapies for prostate can- cer, including radiotherapies and surgical options, are better, safer, and more precise than they have ever been. For those with more aggressive prostate cancer, modern treatment options save lives every day. But even the best and most function-preserving treatments for prostate cancer can some- times severely impact a patient’s quality of life, including bowel dysfunction, sexual im- potence, and urinary incontinence. Given those risks and what we know about the slow-growing nature of many prostate cancers, urologists have been wres- tling with the possibility of post-diagnosis overtreatment for years. But with advanced tools that can accurately predict which pros- tate cancers are likely to metastasize, ac- tive surveillance helps us ensure that more patients with clinically insignificant cancer can avoid multiple biopsies and traditional treatment, reducing the risk of post-biopsy