Sometimes, the best treatment for prostate cancer is no treatment at all. Instead, your care team closely watches the cancer and your health to determine next steps. This process is called expectant management. Active surveillance for prostate cancer is a type of expectant management.
What Does Active Surveillance Mean for Prostate Cancer?
During active surveillance, you regularly have certain exams and tests, including biopsies. These tests allow your care team to closely watch the condition for any changes.
You do not receive any treatment unless there are changes in your test results that indicate cancer is growing or changing. The goal is to find these changes early when the cancer is still curable.
Active surveillance is often confused with “watchful waiting” for prostate cancer. Watchful waiting for prostate cancer also involves watching the cancer without treatment. But it does not involve regular biopsies and testing.
Benefits of Active Surveillance for Prostate Cancer
Some prostate cancers are so slow-growing that they may not cause you any physical harm during your life. Doctors use active surveillance to monitor these cancers. Active surveillance can find early signs that prostate cancer is worsening. It can also help you avoid more invasive treatments, such as surgery and radiation, and their side effects.
Who Should Choose Active Surveillance for Prostate Cancer?
Active surveillance may be an option for you if:
- The tumor has not spread beyond the prostate
- We expect the tumor will grow slowly
- The tumor is small
- You don’t have symptoms
- You have a low PSA level
Doctors base how fast they think a cancer will grow on Gleason score. They determine the Gleason score during a biopsy.
Gleason scores reflect the grade of the tumor, or how abnormal prostate tissue looks. The less normal the cancer appears, the more aggressive (fast-growing) it tends to be. Learn more about the prostate cancer staging.
Prostate Cancer Active Surveillance at the Abramson Cancer Center: What to Expect
At most hospitals, your initial biopsy determines if active surveillance is the best option for you. The next steps are to get a PSA test and then return in about a year for your next biopsy.
If you choose this approach, active surveillance for prostate cancer guidelines say you should undergo:
- PSA test every three to six months
- Digital rectal exam every six to 12 months
- Biopsy every six to 12 months
At the Abramson Cancer Center, our experienced prostate cancer team leads our robust active surveillance program. They create a surveillance plan that considers the full picture of your diagnosis, health and desired quality of life. These plans go above and beyond prostate cancer active surveillance guidelines to include:
Confirmatory Biopsies at the Abramson Cancer Center
Sampling prostate tissue just two millimeters to the right or left of a tumor can affect the accuracy of your diagnosis — and whether active surveillance is best for you.
That’s why we perform confirmatory biopsies. While they are not required by the National Comprehensive Cancer Network, the American Urological Association recommends you have one within two years. If we determine that active surveillance is best for you, you undergo a confirmatory biopsy within three to 12 months of your diagnosis.
We use confirmatory biopsy to confirm the accuracy of the original biopsy. This approach ensures we don’t miss more advanced tumors. Confirmatory biopsies can also give you peace of mind that active surveillance is your best treatment choice.
Advanced Imaging Capabilities
We use advanced imaging techniques to better see and track prostate cancer. In MRI-fusion biopsy, MRI and ultrasound images are combined to create clearer pictures of the tumor and its location.
Using MRIs to guide biopsies reduces “false-negatives,” the need for repeat biopsies and other sampling errors. Our radiologists specialize in using MRI images to watch prostate cancers.
Personalized Surveillance Plans
After we analyze your current biopsy and other test results, we schedule your next set of tests based on our findings and your personal risks. This means we may increase or reduce their frequency based your personal health — not just recommended time increments.
This method helps limit the risks involved with active surveillance. It can also help to increase your comfort with this approach.
Is Active Surveillance Safe for Prostate Cancer?
Most major medical organizations and experts recommend active surveillance as the best available option for low-risk prostate cancer that has not spread beyond the prostate (localized). These organizations include:
- American Society of Clinical Oncology
- American Urological Association (AUA)
- American Society for Radiation Oncology (ASTRO)
- Society of Urologic Oncology (SUO)
Make an Appointment
Please call 800-789-7366 or request a callback.