Active surveillance means your doctor will monitor your cancer with regular PSA tests. If it starts to grow or cause symptoms, then you'll start on a treatment. Prostate cancer often grows very slowly and never becomes life-threatening. Active surveillance lets you delay treatment and avoid side effects, sometimes for many years.
Should I be on active surveillance for prostate cancer?
If your cancer is found early, while it's still small and limited to one area of your prostate, active surveillance may be a reasonable choice. Your Gleason score is low. Active surveillance may be best suited if you have a low Gleason score (usually 6 or lower), which indicates a less aggressive, slower growing form of cancer.
What is watchful waiting for prostate cancer?
Doctors usually recommend watchful waiting for men who are older or who have other serious health problems. With watchful waiting, there are fewer tests. Instead, your doctor will watch to see if you get any prostate cancer symptoms. If you do, you and your doctor will talk about next steps. This could be treatments for the cancer.
Should you treat prostate cancer right away?
If your doctor thinks your prostate cancer is unlikely to grow quickly, he or she may recommend that you don’t treat the cancer right away. Instead, you can choose to wait and see if you get symptoms in one of two ways: Active surveillance.
How effective is active surveillance for men with slow-growing cancer?
Observation and active surveillance are reasonable options for some men with slow-growing cancers because it is not known if treating the cancer with surgery or radiation will actually help them live longer. In active surveillance, only men whose cancer is growing (and therefore have a more serious form of cancer)...
How long can you be on active surveillance?
Is active surveillance safe? Research shows active surveillance is a safe way for men with low risk prostate cancer to avoid or delay unnecessary treatment. And you have the same chances of living for 10 years or more as you would if you chose to have treatment with surgery or radiotherapy.
Is active surveillance considered treatment?
Active surveillance is a form of treatment. It's not the same as receiving no treatment at all. With this method, we put off treatments, such as surgery and radiation therapy, because tests indicate that the tumor is currently not life threatening or is at a low risk of spreading or getting worse.
When do you use active surveillance?
Active surveillance may be used to avoid or delay the need for treatments such as radiation therapy or surgery, which can cause side effects or other problems. During active surveillance, certain exams and tests are done on a regular schedule.
What does active surveillance mean with cancer?
Active surveillance is often used to mean monitoring the cancer closely. Usually this includes a doctor visit with a prostate-specific antigen (PSA) blood test about every 6 months and a digital rectal exam (DRE) at least once a year.
Who is a candidate for active surveillance?
Some of the characteristics that might qualify you for Active Surveillance include grade group 1 or Gleason 6, a PSA level <10, cancer that is confined to the prostate, and/or cancer that is very low volume when biopsied. The ideal candidate for Active Surveillance has low-risk prostate cancer.
Is active surveillance the same as watchful waiting?
Active surveillance may require you to have many biopsies to track cancer growth. Watchful waiting is a less aggressive system of monitoring prostate cancer without treating it. It does not involve regular biopsies or other frequent testing.
Should Gleason 6 Be Treated?
Since the Gleason 6 lacks the hallmarks of a cancer, it is a pseudocancer, not a health risk; does not progress to become a health risk; needs no detection; and needs no treatment.
What is active disease surveillance?
Active Surveillance occurs when a health department is proactive and contacts health care providers or laboratories requesting information about diseases. While this method is more costly and labor intensive, it tends to provide a more complete estimate of disease frequency.
Does Gleason 7 require treatment?
In contrast, patients with Gleason 7 to 10 cancer should consider treatment (i.e., radical prostatectomy or radiation). These patients have a high risk of dying from prostate cancer, and disease-free survival appears to be better after treatment.
What are the criteria for active surveillance in prostate cancer?
It is characterized by a routine protocol of close monitoring with digital rectal examination, periodic biopsy, and serial PSA testing. As defined by D'Amico, active surveillance is broadly appropriate for men with a Gleason score of 6 or less and a PSA level of less than 10 ng/mL.
What are prerequisites for application of active surveillance as a treatment plan in prostate cancer?
You may be offered Active Surveillance if you have low risk prostate cancer defined by: • PSA levels less than or equal to 10ng/ml and • low grade cancer – Grade Group 1 (Gleason score of less than or equal to 3+3=6) and • early stage cancer that is localised within the prostate – tumour stage T1 or T2.
What is considered active cancer treatment?
Treatment given to cure the cancer, such as chemotherapy or radiation therapy. This does not include long-term treatment such as hormone medication, which may be taken for several years to maintain remission.
What is active surveillance for prostate cancer?
Active Surveillance for Prostate Cancer. If diagnosed with localized prostate cancer (cancer that has not spread to distant sites such as bones and lymph nodes), disease management can take many forms, depending on the risk category of disease.
What is the Gleason score for cancer?
It may also be an option for patients with a Gleason score of 7.
Is active surveillance safe?
How to Make Active Surveillance Safer. For carefully screened patients , active surveillance can prevent the unnecessary treatment of prostate cancer. However, this approach is not without potential side effects.
Can you live with cancer without worry?
Your tumor is small and is expected to grow slowly. You aren’t experiencing any symptoms. You have the ability to live with cancer without worry reducing your quality of life. You value near-term quality of life to a greater extent than any long-term consequences that could occur.
Can prostate cancer be monitored?
Patients with low-grade, slow-growing tumors confined to the prostate gland may consider active surveillance. This involves monitoring prostate cancer in its localized stage until your doctor feels that further treatment is needed to halt the disease at a curable stage.
How to check for prostate cancer?
To monitor a low-risk prostate cancer, someone on active surveillance could undergo: 1 Rectal exam : Every six months 2 PSA test : Twice a year. This blood test, commonly used to screen for prostate cancer, measures how much prostate-specific antigen (PSA) is in your blood. 3 Biopsy : Once a year (until and unless your doctor determines a less frequent biopsy is warranted) 4 MRI scan : Necessary in some cases to show more details of a cancer if your doctor has any questions or concerns from your test results
What is the only way to diagnose prostate cancer?
Biopsy results : A prostate biopsy (removing tissue samples from the prostate) is the only definitive way to diagnose prostate cancer today. After a prostate biopsy, your doctor will count how many of the samples contain cancer. For biopsies that show three or fewer samples (or cores) with cancer, your doctor might recommend watching you ...
What is a PSA test?
PSA results : A PSA test is the standard way doctors assess prostate cancer risk. Doctors use PSA test results along with information about your prostate size to measure your PSA density. If PSA density is less than 0.15, you might not need treatment right away.
How do doctors assess prostate cancer?
Physical characteristics : Another way your doctor will assess prostate cancer is through a rectal exam. If he or she can’t feel a cancer (via a hard nodule, for example), that’s another sign that could point to active surveillance as a possible treatment approach.
What is the Gleason score?
Gleason score : This scoring system grades how aggressive a prostate cancer is. It also gives doctors hints as to how likely a cancer is to spread. Gleason scores less than 7 are considered lower risk and might be appropriate for active surveillance.
How often should I get a biopsy?
Biopsy : Once a year (until and unless your doctor determines a less frequent biopsy is warranted) MRI scan : Necessary in some cases to show more details of a cancer if your doctor has any questions or concerns from your test results.
What does it mean to be monitored for cancer?
By not rushing into treatment for a cancer that may not cause you any harm, this approach helps many men avoid treatment-related side effects. Active surveillance , or active monitoring, means your doctor will monitor you closely, watching to see how the cancer progresses, if at all.
What does it mean to watchful wait for a cancer test?
Observation (watchful waiting) is sometimes used to describe a less intensive type of follow-up that may mean fewer tests and relying more on changes in a man’s symptoms to decide if treatment is needed.
Why are men not comfortable with observation?
Other men are not comfortable with observation or active surveillance because the cancer might grow and spread, limiting treatment options and the possibility of treating the cancer successfully. Some men accept the possible side effects of treatments to try to remove or destroy the cancer.
Can prostate cancer be monitored?
Instead, their doctors may recommend observation (sometimes called watchful waiting) or active surveillance.
Is a low PSA level good?
Is associated with low PSA level (<10ng/ml) They are not likely to be good options if you have a fast-growing cancer (for example, a high Gleason score) or if the cancer is likely to have spread outside the prostate (based on PSA levels).
Can you treat slow growing cancer with radiation?
Observation and active surveillance are reasonable options for some men with slow-growing cancers because it is not known if treating the cancer with surgery or radiation will actually help them live longer. In active surveillance, only men whose cancer is growing (and therefore have a more serious form of cancer) are treated.
Can prostate cancer patients live longer after surgery?
Some have found that men who have surgery might live longer, while others have not found a difference in survival.
What is the risk of active surveillance?
A risk of active surveillance is that it can give the cancer a chance to grow or spread. That can limit your options for treatment later. But if the cancer is growing, it will probably be caught and treated. For many men, this never happens, so they don't have any potential consequences of unnecessary treatment.
What is the Gleason score for prostate cancer?
Is only in your prostate. Has a prostate-specific antigen ( PSA) level less than 10 ng/mL. Has a Gleason score of 7 or less, which means your cancer is slow-growing.
Why do doctors want to keep an eye on cancer?
But doctors still want to keep an eye on the cancer so they can take action if it gets worse. This approach is known as active surveillance or watchful waiting. Your doctor may have suggested these options instead of other treatment for a few reasons: Your age. Other health conditions you have, such as heart disease, diabetes, stroke, ...
Can prostate cancer patients live after radiation?
They have found that men with slow-growing tumors who choose active surveillance are likely to live as long after their prostate cancer diagnosis as men with slow-growing tumors who have surgery or radiation right away.
Can you watch for prostate cancer?
With watchful waiting, there are fewer tests . Instead, your doctor will watch to see if you get any prostate cancer symptoms. If you do, you and your doctor will talk about next steps. This could be treatments for the cancer. Or it could be treatments that will control the symptoms.
Can you wait to see if you have cancer?
Not have any symptoms. Feel OK about waiting to see if your cancer grows. (You’re in charge of all your treatment decisions.) Be able to go about your day-to-day life and not worry that your cancer will spread. Understand the benefits and risks of your decision to follow active surveillance.
Do men want to live with cancer?
And they want to try to avoid treatment-related side effects, if they can. On the other hand, some men don’t want to live with a cancer that might be growing, and they want to start treatment right away.
A Protocol Based on Years of Research
In 2018, then-56-year-old Bobby Logan learned he might have prostate cancer after a blood test at a routine physical revealed an elevated prostate specific antigen (PSA) score. A few years earlier, Bobby’s father had received a prostate cancer diagnosis. His father chose to have proton therapy at a hospital in Florida and is now doing well.
Finding a Friend Who Understands
Unfortunately, in March 2021, Bobby’s three-year biopsy revealed that although his cancer was still small and confined to the prostate, the grade had increased. He would need treatment. He met with MSK radiation oncologists and proton therapy experts to learn about his treatment options but decided to have surgery with Dr. Ehdaie.
How much has prostate cancer increased?
There has been a nearly 70% increase in new prostate cancer cases, mostly classified as low risk, that have been diagnosed in early stages as a consequence of prostate-specific antigen (PSA) screening. Data regarding the natural history of …. Prostate cancer is the most common malignancy affecting men. There has been a nearly 70% increase in new ...
Is prostate cancer a low risk disease?
Prostate cancer is the most common malignancy affecting men. There has been a nearly 70% increase in new prostate cancer cases, mostly classified as low risk, that have been diagnosed in early stages as a consequence of prostate-specific antigen (PSA) screening. Data regarding the natural history of this disease confirm ...
What is the best way to monitor prostate cancer?
Closely monitoring the prostate cancer by performing prostate specific antigen (PSA) and digital rectal exam (DRE) tests and prostate biopsies regularly , and treating the cancer only if it grows or causes symptoms. Surgery.
What is the procedure to remove prostate cancer?
Surgery. A prostatectomy is an operation where doctors remove the prostate. Radical prostatectomy removes the prostate as well as the surrounding tissue. Radiation therapy. Using high-energy rays (similar to X-rays) to kill the cancer. There are two types of radiation therapy—. External radiation therapy.
How does ultrasound help with cancer?
High-intensity focused ultrasound. This therapy directs high-energy sound waves (ultrasound) at the cancer to kill cancer cells.
Is it safe to take supplements with complementary medicine?
Meditation, yoga, and supplements like vitamins and herbs are some examples. Many kinds of complementary and alternative medicine have not been tested scientifically and may not be safe. Talk to your doctor about the risks and benefits before you start any kind of complementary or alternative medicine.
What are the treatment options for prostate cancer?
Depending on each case, treatment options for men with prostate cancer might include: Observation or Active Surveillance for Prostate Cancer. Surgery for Prostate Cancer. Radiation Therapy for Prostate Cancer. Cryotherapy for Prostate Cancer. Hormone Therapy for Prostate Cancer. Chemotherapy for Prostate Cancer.
What are the things to consider when making a decision about cancer treatment?
Some important things to consider include: The stage and grade of your cancer. Your age and expected life span.
Why is communicating with your cancer team important?
Communicating with your cancer care team is important so you understand your diagnosis, what treatment is recommended, and ways to maintain or improve your quality of life. Different types of programs and support services may be helpful, and can be an important part of your care.
Why are clinical trials important?
Clinical trials are one way to get state-of-the art cancer treatment. In some cases they may be the only way to get access to newer treatments. They are also the best way for doctors to learn better methods to treat cancer. Still, they're not right for everyone.
What do people with cancer need?
People with cancer need support and information, no matter what stage of illness they may be in. Knowing all of your options and finding the resources you need will help you make informed decisions about your care.
What are the services offered by the American Cancer Society?
These might include nursing or social work services, financial aid, nutritional advice, rehab, or spiritual help. The American Cancer Society also has programs and services – including rides to treatment, lodging, and more – to help you get through treatment.
What is the name of the doctor who treats cancer?
Urologist: A surgeons who treat diseases of the urinary system and male reproductive system (including the prostate) Radiation oncologist: A doctor who treats cancer with radiation therapy. Medical oncologist: A doctor who treats cancer with medicines such as chemotherapy, hormone therapy, and immunotherapy.
Why It's Done
- Active surveillance for prostate cancer is used to avoid treatment side effects when the risk of the prostate cancer progressing is very low. Because prostate cancer grows very slowly, some very small cancers may never cause signs and symptoms. Many who choose active surveillance live …
Risks
- Risks of active surveillance for prostate cancer include: 1. Anxiety.You may be anxious and have a sense of uncertainty about the status of your cancer. 2. Frequent medical appointments.If you choose active surveillance, you must be willing to meet with your health care provider every few months. 3. Cancer growth.The cancer can grow and spread while you wait. If cancer spreads, yo…
What You Can Expect
- During active surveillance, you'll have regular visits with your health care team to monitor the cancer, usually every few months. At these visits, tests and procedures might include: 1. Digital rectal exam.During a digital rectal exam, your health care provider examines your prostate gland by gently inserting a lubricated, gloved finger into your rectum. Your provider can feel the surfac…
Results
- Many who choose active surveillance for prostate cancer never undergo prostate cancer treatment. The cancer may never grow and may never cause signs and symptoms. But prostate cancer treatment might be considered if: 1. The cancer begins growing faster than expected 2. The cancer spreads outside a confined area within the prostate 3. The cancer causes signs and …
Clinical Trials
- Explore Mayo Clinic studiesof tests and procedures to help prevent, detect, treat or manage conditions.