Objectives: To evaluate the concept of active monitoring only in the management of patients with prostate cancer.
Methods: Literature review.
Results: Active monitoring may be recommended in patients with stage T1a, well- and moderately-differentiated disease. Patients with a life expectancy exceeding 10 years are recommended re-evaluation with PSA, TRUS and biopsies of the residual prostate. This treatment is also indicated in patients with stage T1b-T2b, well- and moderately-differentiated tumours and a life expectancy of less than 10 years. Active monitoring is optional in patients with stage T1b-T2b, Gleason 2-4 prostate cancer and a life expectancy of 10-15 years. It is also optional in asymptomatic patients with locally advanced disease, stage T3-T4 which are well- and moderately-differentiated and have a short life expectancy. A very rare asymptomatic patient with M1 disease and the possibility of close follow-up may be offered active monitoring.
Conclusions: Active monitoring is still a viable option for selected patients diagnosed with prostate cancer.