By Chris Adams

One of the key developments in cancer treatment is one that doesn’t actually involve treatment at all.

Known as “active surveillance,” it’s a strategy now employed in a substantial percentage of prostate cancer cases, and it means holding off on any decision to use surgery, radiation or other treatment. Instead, a patient and his physician will agree to undertake a systematic monitoring of the cancer, with regular tests and biopsies to see if the cancer progresses.

This is not the same as doing nothing, and is not the same as the “watchful waiting” buzzword of old. The strategy has been used aggressively at Memorial Sloan Kettering Cancer Center in New York, where Dr. Behfar Ehdaie said it can help patients avoid the side effects of prostate surgery that can mar a man’s later years.

But active surveillance needs to be done right.

“You can’t do it for two years and then stop,” Ehdaie told National Press Foundation fellows. “You have to keep doing it for 20 years.”

In a presentation to National Press Foundation fellows, Ehdaie discussed the emerging research that has made active surveillance an accepted option for many patients. But it’s also one that still faces significant resistance among patients. One study found that 80 percent of doctors felt active surveillance wasn’t being used enough, and that 71 percent of patients weren’t interested in an option that means not treating the cancer inside them.