Prostate Cancer Surveillance
Observation or “watchful waiting” represents a viable option for some patients with prostate cancer. This strategy is indicated in almost all patients with life expectancy less than 10 years. In addition, many younger patients with low risk cancer are candidates for active surveillance. The cancer is observed by following the PSA and rectal exam and repeat biopsies. In this manner, if the cancer were to ‘worsen’ treatment could be instituted. Mciver physicians employ the following strategies in their patients:
Repeat Saturation Biopsy or MRI fusion biopsy
In some patients who wish to observe their cancer, a repeat biopsy can be performed to indirectly determine the extent of the cancer. This can either be performed via the older saturation technique or the new MRI fusion biopsy. In this technique, the patient first obtains a special MRI which can identify prostate cancer and then undergoes a biopsy with MRI guidance
Optimum Hormonal Therapy
Eventually, patients who choose an observation strategy will take hormonal therapy to place the cancer in remission. Hormonal therapy is most often given in the form of injections administered every 3-4 months. Sometimes these are combined with daily pills. McIver physicians can optimize this therapy, by providing intermittent therapy if the patient desires. This has the benefits of limiting side effects of the hormonal therapy, which include hot flushes, fatigue, bone and muscle loss.