Active Surveillance for Prostate Cancer

What is active surveillance for prostate cancer?

Active surveillance for prostate cancer is a way of managing low-risk prostate cancer with regular check-ups and tests instead of cancer treatments, like surgery, chemotherapy or radiation therapy. Low-risk means you have early-stage cancer with a slow-growing tumor.

The goal of active surveillance is to delay cancer treatment until it’s necessary. A recent analysis shows that 6 in 10 of men with low-risk prostate cancer are on active surveillance.

Who qualifies for this treatment?

Active surveillance may be right for you if you have prostate cancer that:

• Hasn’t spread beyond your prostate
• Isn’t considered aggressive according to tumor size, growth or your Gleason score

What happens during active surveillance for prostate cancer?

You’ll have regular physical exams. Typically, once or twice each year, your provider will perform a:

• Digital rectal exam
• PSA test

Every one to five years, you may have a prostate ultrasound and biopsy. Your oncologist may also recommend an MRI-guided prostate biopsy.

Your oncologist may call your treatment “prostate cancer active surveillance protocol” or “guidelines for treatment.”

How long can you be on active surveillance?

You can be on active surveillance for your whole life. Your oncologist checks you regularly to make sure the tumor isn’t getting bigger or spreading outside your prostate. If you have new symptoms or the tumor grows, your oncologist will discuss stopping active surveillance and switching to medical treatment.

How successful is this treatment?

Active surveillance doesn’t treat prostate cancer. But the approach can protect your quality of life by preventing treatment side effects.

What are the potential benefits and risks of active surveillance?

The potential benefit is that you can avoid cancer treatment and its side effects until you need treatment. The risks are that active surveillance can sometimes mean a delay in getting treatment if a tumor starts to grow. When cancer grows, it can spread to other parts of your body (metastasize).

Active surveillance isn’t right for everyone. You may be anxious about having cancer and feel like you should have treatment. You may worry that you won’t know if cancer is growing. Your oncologist will understand your concern. Don’t hesitate to ask questions about what you can expect.

What is the life expectancy of active surveillance in prostate cancer?

You’ll likely have a typical life expectancy if cancer doesn’t grow and symptoms don’t develop. Some men with prostate cancer stay on active surveillance for years after diagnosis.

When should I call my healthcare provider?

Talk to your oncologist if you have new symptoms or your symptoms get worse.

What’s the difference between active surveillance and watchful waiting?

Your oncologist checks on you during active surveillance and watchful waiting. But there are some differences between them:

• Active surveillance involves regular tests to check on the tumor, with the goal of starting treatment when the time is right.
• Watchful waiting involves symptom management. You’ll report any new symptoms to your oncologist, but they won’t do tests.