July 27, 2021

Active Surveillance for Prostate Cancer

If you’ve been diagnosed with prostate cancer, it’s understandable that you want to get rid of the cancerous tissue as soon as possible. However, there are many courses of action that can be taken. For example, your doctor may recommend that you begin aggressive treatment as soon as possible. 

Near the other end of the treatment spectrum is what’s called active surveillance. With active surveillance, prostate cancer is closely monitored but no steps are taken to address it unless some change in its progression makes treatment necessary. The main advantage of active surveillance for prostate cancer is that you avoid the side effects of treatments, which can include incontinence, impotence, reduced sexual desire, and others. 

Monitoring Changes of Prostate Cancer

Your doctor may recommend prostate cancer observation and testing if your condition meets the prostate cancer active surveillance criteria below. 

Your cancer:

  • Isn’t causing any symptoms. For example, it hasn’t affected your ability to urinate.
  • Is expected to grow slowly. This is determined using what’s called a Gleason score. The Gleason grading system is used to evaluate the prognosis for men who have prostate cancer using samples from a prostate biopsy.
  • Is small. Smaller cancers take longer to grow to a size where action must be taken.
  • Is just in the prostate. It’s a good sign if your cancer is “localized.”  
  • Is associated with a low PSA level. Prostate-specific antigen is a protein made by prostate cells that can be measured with a blood test.
  • Isn’t causing worry that affects your quality of life. This is important, as everyone’s affected by a cancer diagnosis in their own way.  

Prostate cancer monitoring for changes or improvement is a good approach for many patients. But you should also be aware that choosing prostate cancer observation means your cancer could spread. If it does, you may have fewer treatment options available to you and they may be more drastic. 

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Protocol for Active Surveillance

If it’s decided that you’ll begin active surveillance following a prostate cancer diagnosis, your doctor will create a testing regimen for you. The typical active surveillance for prostate cancer protocol — and the one recommended by the American Society of Clinical Oncology — includes:

  • PSA testing every three to six months. This is a blood test.
  • A digital rectal exam (DRE) at least annually. This exam’s performed by your doctor with a finger inserted into the rectum to feel for changes in your cancer.
  • A prostate biopsy at least every two to five years. This is the removal of tissue for examination.  
  • Ultrasound or magnetic resonance imaging (MRI). This test may be used if your doctor feels it’s necessary. 

Find a Prostate Cancer Doctor

With active observation, prostate cancer can be managed with less impact on your quality of life. Then, if testing shows that your cancer is progressing faster than expected, treatment is recommended to cure the disease. If you have questions or concerns about treatment or active surveillance of prostate cancer, find a Baptist Health cancer care provider near you.  

Next Steps and Useful Resources:

Find a Cancer Care Provider Near You
Download Your Patient Packet
Cancer Isn’t the Only Prostate Problem Men Face
Men’s Health: Deferred Maintenance (Part 1)
12 Essential Health Screenings for Men

Learn More.