Active surveillance has become a common approach for many men with low‑risk prostate cancer because it minimizes potential harms from immediate treatment. In this view, treatment that carries risks of urinary incontinence or erectile dysfunction may not provide a clear survival advantage for those whose cancers are unlikely to progress. This shift was highlighted in discussions by medical experts a decade ago and remains a key consideration in contemporary care, particularly for patients who prioritize quality of life alongside cancer control. In the present, many clinicians advocate starting with careful monitoring rather than immediate intervention, while remaining ready to initiate treatment if signs of progression appear. This approach is often described as a personalized pathway: regular examinations, periodic imaging, and lab tests guide decisions about when to intervene. The goal is to preserve function and wellbeing without compromising the chance of curative outcomes for low‑risk disease. The overall survival outcomes for men managed with active surveillance are comparable to those who receive definitive therapy for appropriately selected cases. Since choosing a management strategy depends on individual risk factors, age, comorbidities, and patient preferences, a frank discussion with a healthcare professional is essential to align treatment with personal goals and values.
Screening for prostate cancer, while beneficial for some, also carries the risk of overdiagnosis and overtreatment. In the United States and Canada, a portion of cancers detected through routine screening may be low risk and unlikely to cause harm during a patient’s lifetime. The primary screening test used is the blood-based PSA (prostate‑specific antigen) test. A high PSA level can raise concern for cancer, yet not all detected cancers are aggressive or life‑threatening. PSA results can be influenced by factors outside of cancer risk, such as age‑related enlargement of the prostate. These nuances contribute to ongoing debates about screening guidelines and shared decision‑making, emphasizing that screening decisions should be personalized and informed by individual risk and preferences. The current landscape encourages clinicians to weigh the benefits of early detection against the potential for overdiagnosis, overtreatment, and the impact on quality of life.
Modern cancer care also recognizes that historical observations about erectile function and infections require careful interpretation. Contemporary understanding emphasizes accurate diagnosis, evidence‑based treatment options, and patient‑centered decision making to minimize harm while preserving meaningful function. This alignment across specialties helps ensure that men with prostate cancer can pursue effective care without unnecessary compromise to their wellbeing.