Prostate cancer treatment: Active surveillance

Prostate cancer often grows very slowly, which means plenty of men never need treatment. If the cancer is low risk, not causing any problems and isn’t growing quickly, active surveillance can be a good option.

How is prostate cancer
monitored on active surveillance?

Active surveillance allows your doctor to keep a close eye on the prostate cancer without putting you through aggressive treatment. Through regular testing, doctors look out for cancer growth and symptoms.

Depending on your doctor or care team's guidance, here are some tests to expect:

  • PSA tests – your doctor will regularly monitor your blood prostate specific antigen (PSA) levels

  • digital rectal exam (DRE)

  • magnetic resonance imaging (MRI) scan

  • prostate biopsy – that is, taking samples of prostate tissue

You may also have other blood and urine tests, but your doctor or care team will speak with you about your plan.

Being a good candidate
for active surveillance

Doctors look at a number of factors to determine if active surveillance is suitable for you, including your:

  • PSA levels

  • cancer type – active
    surveillance can be suitable for men with low-risk, localized prostate cancer

  • age and current health
    being younger with a good level of health and fitness may help the case for going on active surveillance

After carefully reviewing all factors, your doctor or care team will tell you if they recommend active surveillance. If you're a good candidate, the goal will be to keep an eye on cancer growth and catch any problems early. This approach helps you avoid treatment you may not need at the moment. However, if cancer turns out to be more aggressive than your team first thought, they may recommend moving from active surveillance to a different treatment.

Are there side effects
to active surveillance?

Active surveillance does not cause physical side effects. However, alert your care team if you begin to experience these issues:

These issues could be signs that the cancer is growing and may need further treatment. Your team will work with you to monitor health problems, along with your PSA, to determine if active surveillance is still the best option.

While on active surveillance, you might also have prostate biopsies. The biopsy can cause some side effects, but they should be manageable.

Is active surveillance
different from watchful waiting?

You may have heard that they're the same, but active surveillance differs from

in at least 3 ways:

  • Active surveillance involves regular check-ups with your doctor to monitor your PSA and check for signs of cancer growth. If your PSA levels rise and other testing confirms that the cancer is growing, your doctor will discuss further treatment options.

  • If at some point you decide to get further treatment after active surveillance, the goal will be to cure cancer and manage symptoms.

  • Active surveillance is mostly suitable for men with localized prostate cancer, whereas watchful waiting may be suitable for localized, locally advanced and advanced prostate cancer.

What's next?

Now that you've read up on Prostate cancer treatment: Active surveillance, here are some related articles to explore as you continue to build your knowledge and understanding of this topic.
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