Question:
I am a 67 years retiree man. I've recently been diagnosed with prostate cancer; after my preliminary medical and paramedical investigation, my doctor told me an active surveillance protocol would be appropriate. What is that, and could that be a good option?
Answer:
Evidence shows that early treatment with surgery or radiation prevents relatively few men from ultimately dying from prostate cancer while leaving many with urinary or erectile problems and other side effects.
Many men diagnosed with prostate cancer don't need to be treated right away. This is because most prostate cancers grow slowly and are unlikely to spread outside of the prostate. Those with localised prostate cancer with a very low risk of growing quickly may be offered active surveillance. This means that your healthcare team watches cancer closely rather than giving treatment right away. During active surveillance, the cancer is closely monitored for signs with tests and exams to check if prostate cancer is growing or spreading or if your condition is worsening. Treatment is given when you develop symptoms or the cancer changes.
You may be offered active surveillance if:
The cancer is small, confined to the prostate, has no symptoms, low Gleason grade, PSA less than 10ng/ml, and when you prefer not to have treatment right away so you can avoid treatment-related side effects and keep the quality of life that you're used to
During active surveillance
You will have tests every 3 to 6 months to monitor cancer. Tests may include:
The PSA test includes a digital rectal exam (DRE), a prostate biopsy, a bone scan, a chest x‑ray or CT scan, depending on the signs and symptoms that develop, and an MRI of the prostate in some cases.
Treatments, such as surgery or radiation therapy, are started if:
The PSA level keeps increasing over time, samples show a higher Gleason score, and symptoms develop.
A Naturopathic doctor can play an important role in participating in the so-called ''Holistic Active Surveillance protocol'' by educating the patient about diet, and lifestyle changes, talking about pro-inflammatory and anti-inflammatory diets and using evidence-based supplement therapy when needed.
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