Dr. Claire de la Calle

Because that's time without the side effects of treatment.

And so if we can safely monitor a patient for even just a couple of years,

and then the patient undergoes a radical prostatectomy or radiation, I think that's great, as long as they have similar oncologic outcomes than the patients that chose upfront treatment.

They need to be committed to follow-up, so I definitely need to tell them from the very first day what they should expect.

And so that protocol that we mentioned earlier, how regular they're going to need to get biopsied, because, of course, these poor patients, they just underwent a prostate biopsy.

You're already talking to them about getting another one.

They need to be willing to undergo that and all the other monitoring that goes with it and not forget about their cancer because these cancers obviously can progress.

In terms of patient anxiety, I think a lot of the anxiety also comes from the provider.

And for low-risk patients, I think now we have such strong data that supports active surveillance.

It's easy for us providers to not have any anxiety around active surveillance, but I think it's not as easy for intermediate risk.

I mean...

There are so many patients that are kind of borderline.

We don't we don't really know.

And so, well, on the one hand, I don't want to transfer anxiety to my patients.

On the other, I also I want to be completely honest about everything I'm thinking about.

And so if I'm telling them, look, I don't I'm not 100 percent sure.

Let's continue monitoring.

And I tell them to try to reassure them, let's give this cancer some time to tell us what type of cancer it is, to tell us what its true biology is.

And sometimes that I find that that helps reassure the patient that this is just like a temporary thing.

And if it's looking like it's progressing based on PSA or anything else, then we're not going to hesitate and we're just going to go ahead and