Active surveillance for early prostate cancer

Some early prostate cancers grow very slowly and do not cause any symptoms. This means they may never need any treatment. In this situation, your doctor may offer you active surveillance. Active surveillance means you will not have treatment for prostate cancer straight away. Instead, you will have regular tests to check whether the prostate cancer is growing. Your doctor may monitor you and you may be offered some tests, such as:

  • an MRI scan when you start active surveillance, if you have not had one before
  • a rectal examination every 6 to 12 months
  • blood tests every 3 to 6 months to check your PSA levels
  • a prostate biopsy or an MRI scan after 1 year of active surveillance.

If the cancer is not getting any bigger or growing more quickly, it is safe to continue with active surveillance. Some men on active surveillance may never need treatment for prostate cancer.

If any of the tests show the cancer is starting to grow more quickly, your doctors will recommend surgery or radiotherapy to try to cure the cancer.

Advantages of active surveillance

  • You can avoid or delay having treatment such as surgery or radiotherapy.
  • You can avoid or delay the side effects of treatment.

Disadvantages of active surveillance

  • You may find it difficult to wait and see whether the cancer grows before starting any treatment.
  • Very rarely, a cancer that has progressed during active surveillance may not be curable. But if this happens, the cancer can be controlled with long-term hormonal therapy.

Back to Monitoring prostate cancer

Watchful waiting

Watchful waiting is usually offered to older men who have a slow-growing prostate cancer that's unlikely to affect their natural life span.