Treatment Planning - Active Surveillance

Active surveillance is when doctors monitor prostate cancer over time instead of starting immediate treatment. Treatment is initiated if it becomes necessary in the future. Active surveillance aims to avoid potentially harmful treatments for patients whose cancers aren’t a big health risk, preserving their quality of life as long as it is safe to do so. It focuses on your individual needs, striking a balance between controlling cancer and maintaining your wellbeing.

Many large studies over the past several decades have shown that active surveillance is a safe choice for patients with certain early-stage prostate cancers. In fact, for men with these low-risk cancers, undergoing treatment did not provide any advantage over choosing initial active surveillance. But what does active surveillance involve?

What tests are included in Active Surveillance?

Active surveillance usually involves regular tests to see whether the cancer is changing at all. You would have a prostate-specific antigen (PSA) blood test every six months as a way to non-invasively monitor the cancer. It is important to know that PSA levels do naturally fluctuate quite a bit, so it is expected that the PSA will change from one test to the next. Periodic MRI scans are also done to check for any growth or changes in the cancer.

Because prostate biopsies are the most accurate way to assess the cancer, you’ll have repeat biopsies periodically to check the cancer’s Gleason grade. This will show whether the cancer itself is changing over time. If the cancer’s Gleason grade increases, it may mean the cancer is changing which would indicate the need to switch from surveillance to treatment (such as surgery or radiation).

Overall, Active surveillance greatly helps in managing prostate cancer in patients with low-risk disease. By putting your health and quality of life first while making sure the cancer is under control, Active surveillance carefully helps balance quality of life with the risk posed by the cancer. In the modern era of prostate cancer care, Active surveillance is the standard of care management approach for patients with low-risk prostate cancer.