For prostate cancer found at an early stage, which is of low risk, active surveillance may avoid or delay treatment without risk to your health. Treatments for prostate cancer often cause side-effects that can affect your quality of life, so you could choose to have active surveillance rather than treatment.
Who can have active surveillance?
What does active surveillance involve?
What happens if the results of my tests change?
- PSA: A rise in your PSA level may be a sign that your cancer has started to grow. If this happens, your doctor will look at how quickly your PSA is changing. If your PSA level is rising, your doctor will discuss if you need to have treatment or not.
- Biopsy results: You may be offered treatment if your repeat biopsy shows a change in the amount or the grade of cancer; for example, if the biopsy detects some cancer with a higher Gleason score.
- Digital rectal exam: If your doctor feels any changes during a physical exam, he or she will discuss with you if you need treatment or more tests.
Is active surveillance risky?
Even though the tests can pick up changes, there is also a chance that changes in your cancer may not be picked up. There is also a small chance that your cancer will be faster growing than first thought. This is why the biopsy is repeated.
Advantages of active surveilance
- No physical side-effects
- Does not interfere with everyday life
- You may never require the treatment of the prostate cancer
Disadvantages of active surveillance
- You may become anxious or worried about your cancer changing
- Repeat biopsies are needed
- The cancer may grow more quickly than expected
If you are considering active surveillance as an option it may be helpful to ask some of the following questions so that you know what to expect in the future as well as understand how your follow-up will be managed, and by whom:
- How often will I need to have my PSA level checked?
- Who will check my PSA level and give me the results?
- How often will I have to go back for check-ups?
- How often will I have a digital rectal examination?
- When will I need repeat prostate biopsies and how often?
- How quickly would my PSA level have to rise for treatment to be considered necessary?
- What treatments could I have if my cancer grows
Remember your active surveillance appointments
- It is very important to keep any future appointments that are arranged for you as part of your active surveillance programme.
- Write the date and time down on a calendar to remind yourself closer to the time.
- If you cannot make the arranged appointment then make one for another day by contacting the urology clinic in the hospital and speak with your prostate cancer nurse specialist.