You may be offered Active Surveillance if you have low risk prostate cancer defined by:
- PSA levels less than or equal to 10ng/ml and
- low grade cancer – Grade Group 1 (Gleason score of less than or equal to 3+3=6) and
- early-stage cancer that is localised within the prostate – tumour stage T1 or T2.
Some men with intermediate risk prostate cancer, who have only a small amount of Grade Group 2 disease may also be offered Active Surveillance.
More information about prostate cancer grading, staging and risk can be found in Prostate cancer – a guide for newly-diagnosed men.
Benefits of Active Surveillance
- The cancer is closely monitored. Clinical trials have shown this to be a very safe method of treatment.
- Avoids or delays the side effects associated with radical treatments (e.g. surgery or radiation therapy).
- Radical treatment may never be needed if monitoring suggests the cancer is not growing or spreading. Possible side effects of Active Surveillance.
- There is a small chance of pain, bruising and bleeding from the biopsy.
Things to consider
- Some men worry about not doing anything to treat the cancer.
- Regular digital rectal examinations and biopsies are needed.
- There is always a risk that a progressing prostate cancer may not be identified.
Sometimes Watchful Waiting is used for prostate cancer management instead of Active Surveillance. It is often recommended for men with other health issues and/or men who are not expected to live more than 10 years. The aim of Watchful Waiting is to monitor and treat symptoms caused by the prostate cancer if they arise. It involves fewer tests then Active Surveillance. If the cancer progresses, men are treated with hormone therapy or androgen deprivation therapy rather than a treatment that aims to cure the cancer such as surgery or radiation therapy.