A recent study from Johns Hopkins University School of Medicine published in the Journal of Clinical Oncology concluded that for men over 65 “active surveillance is the first option for men in this category with very-low-risk disease” according to senior investigator Dr. H. Ballantine Carter. The initial question for such patients should be “whether any therapy is appropriate for them, not which therapy.” The clinical definition of “very-low-risk prostate cancer is provided in the article initially published in the April 19th, 2011 issue of the National Cancer Institute (NCI) Cancer Bulletin. At Johns Hopkins, the active surveillance program involves a semi-annual check up and an annual biopsy. Among the 769 men enrolled in the Hopkins active surveillance program from 1995-2010, approximately 80% had very-low-risk disease as defined by their Gleason score and other factors listed. Overall, 41% of the men in this study did not require any form of treatment even after ten years of follow-up, providing evidence that “active surveillance” is safe. For additional information, see the July 24th, 2012 issue of the NCI Cancer Bulletin.