Why Active Surveillance?

Many prostate cancers are diagnosed early with PSA testing. Active surveillance aims to delay and prevent treatment related side effects on those men who have prostate cancers which are unlikely to need treatment find those men whose cancers are likely to grow and cause issues ensure that those men requiring treatment are still at a curable stage.

Active surveillance involves monitoring prostate cancer rather than treating immediately.

What is involved?

Typically, active surveillance requires regular reviews consisting of PSA testing, Digital rectal examinations (DRE), Repeat prostate MRI scans +/- and repeat biopsies of the prostate.

Who is suitable for active surveillance?

You are suitable for active surveillance if you have Localised prostate cancer (i.e. cancer only within the prostate gland), a low PSA (usually <10), or a low Gleason score (usually ≤6). However, depending on your individual situation, active surveillance may still be offered even if your cancer has slightly higher risk features.

Watchful waiting versus active surveillance:

Watchful waiting is different from active surveillance. Watchful waiting aims to treat only when symptoms arise or metastatic disease (cancer outside of the prostate gland) becomes apparent. Watchful waiting involves less monitoring compared with active surveillance.  It is usually offered to older men, men in poor health and men who would do poorly with prostate cancer treatment.

What are the advantages and disadvantages of active surveillance?

Advantages: As there are no physical treatments, there are no physical side effects. There is less interference with life, as treatment is currently being delayed

Disadvantages: Some men become anxious about not treating prostate cancer. More TRUS/TP biopsies are/maybe required with the potential for procedural side effects.