Many prostate cancers are small and slow growing, the so called non-aggressive tumours. Yes it is still a cancer, with all the fear that arrives with the diagnosis, but it is unlikely to impair your life or be the cause of your death unless it takes an unexpected turn for the worse.

In these cases, it is likely the man will be offered an alternative to ‘curative’ treatment such as surgery or radiation in the form of Active Surveillance (AS), known as Active Monitoring (AM) in the UK. This option involves regular monitoring of key indicators of cancer aggressiveness such as the Prostate Specific Antigen doubling rate (dPSA) and/or the Gleason score on subsequent biopsies, and/or ultrasound or MRI imaging of the prostate. These check-ups will provide an early indication of a change of the mood of the prostate cancer and may prompt a new strategy of moving on to treatment or the reassurance of continued surveillance.

Many men remain on AS for years until they either reach an age where it is deemed no longer necessary to keep watch, or they die from another cause.

Why follow the AS pathway? Simple – to avoid the life-changing side-effects that may accompany curative treatment. Side-effects such as incontinence, erectile dysfunction and depression. The cancer itself rarely causes any symptoms, however the treatments certainly do. Remaining on AS for as long as medically possible ensures an ongoing quality of life involving erections, no pads in your underwear and being able to socialise, work, play and rest with no fear.

The surveillance is important and must be adhered to if a man is to monitor his risk. But there is an other side to the program – the ACTIVE part. And this is where the man can take some control of his own destiny. The activities he chooses to do (or not do), the foods he consumes (or avoids) and the way he manages stress in his life can all influence the cancer in his prostate. None of these things is likely to cure it, but they may sabotage any progression.

For a lot more information, in fact this is all that the book is about, check out The Prostate Playbook to learn how to tweak your lifestyle and undermine your prostate cancer. Hopefully you can avoid surgery, radiation or other treatments forever.