Andrew Stephenson, MD, director of Urologic Oncology, Cleveland Clinic, discusses patient preferences with undergoing active surveillance versus active treatment for their prostate cancer.

Historically, rates of active surveillance in the United States have been substantially lower than in other countries, particularly Europe and even in Canada, Stephenson explains. The earlier notion was that American patients were more risk-adverse and not willing to accept the potential risks of having progressive cancer, relative to patients in Europe or Canada.

However, he adds, it is more critical in the message that clinicians deliver to patients. If their discussions are data driven in how they explain the various treatment options, patients are relieved to hear that they have a low-risk cancer and do not need to undergo aggressive treatment.

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Dr. Stephenson on Patient Preferences on Undergoing Active Surveillance for Prostate Cancer

Andrew Stephenson, MD, director of Urologic Oncology, Cleveland Clinic, discusses the impact of active surveillance on the field of prostate cancer.

There has been an important paradigm shift in the management of this disease, Stephenson explains. It positively impacts quality of life compared with other therapies for patients with localized prostate cancer, such as surgery and radiation therapy. There have been important developments evolving the techniques of these treatments, but there is still a negative impact on urinary, bowel, and sexual function by many patients treated with these modalities. 

The aggressiveness of prostate cancer has changed substantially, he explains. Therefore, by subjecting all patients to treatment for prostate cancer, clinicians may be subjecting them to harm without any real, clear benefit, Stephenson adds. 

Andrew Stephenson, MD

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Dr. Stephenson on Patient Preferences on Undergoing Active Surveillance for Prostate Cancer

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