Active Surveillance for Prostate Cancer

1 What is an Active Surveillance for Prostate Cancer?

During the active surveillance for prostate cancer, your doctor will closely monitor your prostate for any changes.

Active surveillance for prostate cancer can also be called watchful waiting.

No treatment for cancer is administered during active surveillance for prostate cancer. This means medications, radiation, and sugery cannot be used.

Periodic tests are also done to to check if the cancer is growing.

You might consider active surveillance for prostate cancer if your cancer is small, expected to grow very slowly, cofined to one particular area or your prostate and is not causing any signs or symptoms.

If you have had any other health problems that limit your life expectancy, active surveillance for prostate cancer can be a reasonable approach.

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2 Reasons for Procedure

Active surveillance procedure for prostate cancer is used to avoid treatment side effects in men with a very small risk of prostate cancer progression.

For the reason, that prostate cancer grows very slowly, men who are diagnosed when cancer is very small and may never have signs and symptoms of the disease.

Many may live out their normal lifespans before cancer ever grows large enough to require treatment.

Active surveillance for prostate cancer may be appropriate for you if:

  • Your cancer is small
  • If your cancer is found early while it is still small and limited to one area of your prostate

Another reason is if your Gleason score is low. A low Gleason score will usually indicate a less aggressive, slower growing (form of cancer).

If you have other advanced health problems, such as severe heart disease, which can limit your life expectancy and could be potentially aggravated by treatment of prostate cancer, you may opt for active surveillance.

3 Potential Risks

The potential risks of active surveillance may include the following:

  • Anxiety, cancer can grow and spread while you wait

If this cancer spreads, you may miss the chance to treat it. Men who choose active surveillance must be willing to make appointments every few months.

Another potential risk revolves around the fact that there are fewer treatment options.

If your cancer spreads, you may have fewer options for treatment.

4 What to Expect

Here’s what you can expect during and after your active surveillance procedure for prostate cancer:

During active surveillance, the doctor will monitor cancer, usually ever few months.

At these visits, your doctor may perform the following tests and procedures:

A digital rectal exam

During this exam, your doctor examines your prostate gland by gently inserting a lubricated, gloved finger into your rectum. Your doctor can feel the surface of the prostate and assess if cancer has grown.

PSA blood test

A doctor can also conduct a PSA blood test which measures the amount of prostate-specific antigen in your blood. If the levels of PSA rises, it is usually an indication of cancer growth.


If other tests raise concerns, your doctor may use transrectal ultrasound to further evaluate your prostate. A small probe, similar in shape and size of a cigar, is inserted into the rectum.

The probe uses sound waves to create an image of your prostate gland. A collection of prostate cells (prostate biopsy).

Collecting a sample of cells growing from the inside of your prostate is usually recommended one year after active surveillance is initiated.

Biopsy may be occasionally repeated, as your doctor recommends, to determine how much cancer has grown and to re-evaluate your Gleason score to see if cancer remains developing slowly.

5 Procedure Results

Men who make a choice to go ahead with active surveillance for prostate cancer never undergo prostate cancer treatment.

As a result of the procedure, cancer may never grow, and these men may live out their normal life spans.

However, other men may choose to treat prostate cancer if :

  • Cancer begins to develop faster than previously expected,
  • Cancer spreads to an out region within the prostate
  • and cancer causes signs and symptoms.

Treatment options for prostate cancer depend on your individual situation, but may also include surgery, medications, and radiation.