Brian F. Chapin, MD, assistant professor, Department of Urology, Division of Surgery, The University of Texas MD Anderson Cancer Center, discusses impact of active surveillance in the field of prostate cancer.

There has been a large, national increase in the number of patients going onto active surveillance programs, Chapin explains. Compared with the smaller proportion seen previously, researchers now are seeing that up to 40% of men who are diagnosed with low-risk tumors are going onto an active surveillance program.

Additionally, he says, the community is recognizing that not all prostate cancers are the same. Some prostate cancers are indolent and are unlikely to cause significant problems. Patients are becoming more aware of that; therefore, they are seeking out other options and not just choosing to go with active treatment.

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Dr. Chapin on Impact of Active Surveillance in Field of Prostate Cancer

Brian F. Chapin, MD, assistant professor, Department of Urology, Division of Surgery, The University of Texas MD Anderson Cancer Center, discusses the considering factors for a patient with prostate cancer to undergo active surveillance versus active treatment.

The ways physicians risk stratify patients into the low-risk category is mainly by Gleason scoring, Chapin explains. This is a pathologic assessment of the tumor, and we identify Gleason score 6—which is grade 3 + 3 tumors&mdash;as being low risk and having low metastatic potential.

Additional factors such as prostate-specific antigen and digital rectal exam are used to categorize patients in the low-risk group. Physicians at The University of Texas MD Anderson Cancer Center, Chapin adds, use a protocol-based program that involves a confirmatory biopsy within 6 months of the original biopsy, and planned assessments every 6 months with a digital rectal exam and PSA test.

Every 1 to 2 years, a repeat biopsy and/or MRI-scan imaging is done to better assess the patient’s situation and make changes as the disease evolves.

Brian F. Chapin, MD, assistant professor, Department of Urology, Division of Surgery, The University of Texas MD Anderson Cancer Center, discusses the considering factors for a patient with prostate cancer to undergo active surveillance versus active treatment. 

Brian F. Chapin, MD

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