Active Surveillance

Watching closely to see if prostate cancer grows.

Doctor looking at prostate scans

What is active surveillance?

In many cases, early-stage prostate cancer will not spread or cause health problems for years, if ever. That’s why your Legacy Cancer Institute doctor may recommend an approach called active surveillance or watchful waiting.

Active surveillance is the decision to not treat prostate cancer right away, but rather to watch it closely, which may include monitoring your PSA levels (using a blood test that measures the protein specific antigen). If the cancer grows or causes health problems, you can choose to have treatment at that time.

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When active surveillance is an option

A plan of active surveillance may be a choice for you if:

  • Your doctor believes your cancer is growing slowly
  • Your tumor hasn’t spread
  • There is a limited amount of cancer in the prostate.
  • Your cancer is less aggressive.
  • Your PSA score is less than 10 and your Gleason score is 6 or less.
  • Your age is 65 years or older.
  • You have other health problems.

Talk to your doctor

The idea of active surveillance (watchful waiting) is not accepted by everyone. The assessment of prostate cancers is not a perfect science, and the decision to offer active surveillance varies from doctor to doctor. Also, certain treatments for very small tumors may cause few side effects. In addition, some men are not comfortable with “waiting”; they want the cancer treated or removed without delay. 

However, men with a small amount of non-aggressive prostate cancer should consider active surveillance, in consultation with their doctor.

Your doctor will work with you to understand the stage (progress) of your cancer and what treatment options are available to you to help plan for your next steps.

What to expect

You will see your doctor regularly to monitor whether the cancer is growing. Among the tests you may have are:

  • A blood test every few months to check your protein specific antigen (PSA), the marker for prostate cancer
  • A digital rectal exam (DRE) 
  • Needle biopsy
  • Ultrasound
  • Fusion biopsy

If  your PSA rises or if you have other signs that the cancer is growing, you and your doctor can decide whether you want to start treatment

You should also talk with your doctor if you feel symptoms of prostate cancer –– changes in urination or sexual function, or pain in the rectum, lower back, hips, pelvis or thighs.  

More support

You are not alone. Legacy offers support throughout your cancer journey, as well as care for your emotional, social and spiritual needs. 

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