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Active Surveillance for Prostate Cancer

This information explains a treatment for prostate cancer called active surveillance.

Active surveillance is an option for men whose prostate cancer is believed to represent little threat to either how long a man lives or the quality of his life.

Many prostate cancers grow slowly and do not cause problems, while others progress more quickly. Based on your test results, your doctor can judge how quickly the cancer in your prostate will grow. If you have a slow-growing cancer, your doctor may suggest active surveillance.

During active surveillance, prostate cancer is monitored over time, instead of having surgery or radiation therapy. As long as your risk of the prostate cancer growing remains low, your doctor will keep monitoring it. If your risk of the prostate cancer growing gets higher, then he or she will recommend treatment, such as surgery or radiation therapy, with the goal of curing your cancer.

During active surveillance, your doctor will use different tests to watch for any changes in your prostate, including:

  • A blood test that measures your prostate-specific antigen (PSA) level. PSA is a protein made by your prostate gland
  • A digital rectal examination (DRE), which is performed to check for abnormalities in your prostate, such as hardness
  • A biopsy of your prostate, which uses a needle to obtain samples of tissue. The samples are checked for signs of cancer and given a Gleason score, which helps your doctor determine how likely it is that the cancer will threaten your health
  • Magnetic resonance imaging (MRI) of your prostate, which provides information about the location and extent of the cancer

If you and your doctor have decided that active surveillance is right for you, your doctor will discuss with you which tests you need and how often you need them. Below are guidelines for what tests you can expect and when, but it's important to follow the schedule your doctor prescribed for you.

  • DRE and a PSA test every 6 months.
  • In some situations, it may be necessary to have your PSA test performed at a lab closer to your home. If you and your doctor have discussed this option, please fax the results to:

    Dr. ______________________ at _____________________ (fax).
  • Biopsy and/or MRI of your prostate.
  • A prostate biopsy and/or MRI are usually done within 6 months of your diagnosis. This is to confirm that your cancer is low risk and that you are a candidate for active surveillance.
  • A prostate biopsy and/or MRI are repeated every 1 to 3 years.