Rigi10™ Malleable Penile Prosthesis
Also Known As
Active surveillance, watchful waiting, expectant management, observation, surveillance protocol, monitoring protocol, deferred treatment
Definition
Active monitoring, also known as active surveillance, is a strategy of closely observing a condition without immediate treatment, intervening only if progression occurs.1 This approach involves regular monitoring through scheduled tests and examinations to track any changes in the condition.2 It is primarily used for conditions that are slow-growing or pose minimal immediate risk, particularly in cases where the potential side effects of treatment might outweigh the benefits of immediate intervention.3 Active monitoring allows healthcare providers to delay or avoid unnecessary treatments while maintaining the ability to intervene promptly if the condition worsens.4 This approach is most commonly implemented in the management of low-risk prostate cancer but can be applied to other conditions as well.5
Clinical Context
Active monitoring is primarily utilized in clinical settings where immediate intervention may not be necessary or beneficial.1 The most common application is in the management of low-risk prostate cancer, where it has become the preferred approach according to major clinical guidelines.2 This strategy is particularly appropriate for patients with small, slow-growing tumors that are confined to a specific area and not causing symptoms.3
Patient selection criteria for active monitoring typically include:
- Low-risk disease classification (e.g., low Gleason score in prostate cancer)4
- Limited disease extent (e.g., confined to one area)3
- Absence of symptoms related to the condition3
- Consideration of patient age and comorbidities that might limit life expectancy4
The monitoring protocol generally involves:
- Regular physician visits (typically every 3-6 months)4
- Periodic blood tests (e.g., PSA testing in prostate cancer)4
- Imaging studies at defined intervals (e.g., MRI)5
- Repeat biopsies when indicated by changes in other parameters5
Expected outcomes with active monitoring include:
- Avoidance of unnecessary treatment side effects for many patients4
- Preservation of quality of life during the monitoring period4
- No significant impact on cancer-specific survival for appropriately selected patients5
- Potential for delayed intervention if progression is detected5
The decision to transition from active monitoring to active treatment is typically based on evidence of disease progression, such as rising biomarker levels, changes in imaging findings, or worsening symptoms.5