Cancers sometimes never grow, or may do nothing for 10 years, so in a sense, if you prematurely treat it on Day 1, you may have affected your life for 10 years, when you never needed treatment.
However, when you do active surveillance, there are some cancers that can actually grow. When that happens, we want to be able to detect and catch it before it gets too significant or too advanced. You are trying to detect cancer before it is dangerous and while it’s growing.
It turns out, as shown in the PROTECT study, half of the men in the active surveillance group for 10 years, never needed treatment. But about the other half of the men on active surveillance did need treatment. And most of those guys who needed treatment, got treatment and were still cured.
One simple advantage of active surveillance is you get to delay the side effects of treatment or potentially avoid the side effects altogether, if you never needed treatment. Another advantage is, if you wait, luckily the treatments are improving – we are getting new treatments, better treatments and whatever treatments we have now are becoming more refined or precise. By simply waiting 5-10 years, you will be getting a better treatment.