What is Active Surveillance?

Active surveillance is a management approach for low-risk, early-stage prostate cancer. It involves closely monitoring the disease for any signs of progression, while avoiding immediate treatments like surgery or radiation and their associated side effects.

Who Should Consider Active Surveillance?

Men with low-risk, early-stage prostate cancer may want to consider active surveillance in consultation with their doctor. Around 50% of men diagnosed with prostate cancer have low-risk disease, which is unlikely to spread and often does not require aggressive treatment.

For those considering active surveillance versus surgery, studies suggest that men with low-risk prostate cancer can safely delay a radical prostatectomy for up to 12 months after diagnosis.

Active surveillance can be particularly valuable as it helps men avoid the side effects of more invasive treatments while still closely monitoring the cancer’s progression.

How Does Active Surveillance Work?

With active surveillance, your doctor will closely monitor your prostate cancer to check for signs of progression or increased aggression. This typically involves regular tests such as PSA tests, digital rectal exams, biopsies, and possibly additional imaging tests. Through careful monitoring, your healthcare team can track any changes and determine if more aggressive treatment is necessary.

If your doctor recommends active surveillance, make sure to establish a clear plan for follow-up tests and understand the next steps in case the cancer progresses.

WATCHFUL WAITING

  • Fewer tests than Active Surveillance.
  • Ideal for older men and men with health problems that could make treatment difficult.
  • 70-80% of men in their 80’s have prostate cancer and not all need to be treated.

Active Surveillance vs. Watchful Waiting

The terms “active surveillance” and “watchful waiting” are sometimes used interchangeably, but they are actually employed in different circumstances.

Watchful waiting is typically recommended for older or less healthy men with a shorter life expectancy, where prostate cancer treatment may be challenging or potentially harmful. While regular tests are still done to monitor disease progression, they are generally less frequent than in active surveillance, and repeat biopsies are usually avoided.