Active urological surveillance
What is it?
Active surveillance involves serious radiologic checks over time and is the strategy of choice in patients who have relatively non-aggressive disease compared with other general health problems.
When is this procedure indicated?
In case of oncological risk, surveillance is stopped and the patient becomes a candidate for active treatment. If the patient is selected correctly, there is no risk of worse disease control with active treatment after surveillance. Finally, it is the treatment option that is associated with the least damage to renal function, which is not affected.
How is it performed?
Active surveillance involves a protocol of radiological examinations that monitor renal tumor and its eventual evolution. Examinations can be ultrasound, CT scan of the abdomen with contrast medium, and MRI. The frequency of examinations is higher in the period following diagnosis (e.g., quarterly or semiannually for the first few years after diagnosis) and increases thereafter if the lesion is stable (e.g., annually). Any changes in the evolution of the lesion may indicate the need for active treatment.
Almost none. Possible problems for the patient may be anxiety or worry related to the diagnosis.
Vary rarely, in case of incorrect patient selection, the disease could progress in absence of treatment, being accompanied by worsening of symptoms and appearance of distant lesions.
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