Active Surveillance for prostate cancer – the past, present, and future

Peter Carroll, MD, MPH, of the University of California, San Francisco, is one of the true pioneers of Active Surveillance for men with low-risk prostate cancer. In this talk, Dr. Carroll reflects on more than two decades of progress — from the early days when nearly every prostate cancer was treated aggressively, to the present, where Active Surveillance has become a safe, evidence-based standard of care for most men with lower-risk disease. He also looks ahead to the future of screening, biomarkers, MRI and micro-ultrasound imaging, genomics, focal therapy, and even AI in prostate cancer management. Dr. Carroll was honored with the 2024 Chodak Award by Active Surveillance Patients International (ASPI) for his leadership in developing and advancing the Active Surveillance approach. The award is named for the late Dr. Gerald Chodak, who laid the foundation for this conservative and patient-centered way of managing prostate cancer. CHAPTERS 03:57 – Dr. Peter Carroll: Reflections on the early days of Active Surveillance 15:45 – How evidence and trials shaped today’s standard of care 25:52 – The role of MRI, biomarkers, genomics, and focal therapy 33:40 – Looking ahead: screening, AI, and personalized monitoring 38:23 – Q&A: what the next decade may bring KEY POINTS ✅ Dr. Peter Carroll (UCSF) helped pioneer Active Surveillance as a safe option for men with low-risk prostate cancer. ✅ Early research showed many men were overtreated, motivating the shift toward monitoring rather than immediate surgery or radiation. ✅ Advances in MRI, genomics, and biomarkers now help identify which men can safely stay on surveillance. ✅ The future of prostate cancer care lies in precision monitoring, AI-driven imaging, and smarter screening strategies. ✅ Dr. Carroll’s decades of work helped redefine prostate cancer management worldwide — earning him ASPI’s 2024 Chodak Award for leadership in patient-centered care. Learn more: Visit aspatients.org for upcoming meetings, educational videos, and patient resources on Active Surveillance. Support ASPI: If you value these educational programs, please consider a donation to support our mission: aspatients.org/donate. Please note: This video is for educational purposes only. ASPI does not provide medical advice or treatment recommendations. Always consult your healthcare provider about your individual situation.