Explainer: Active Surveillance for Prostate Cancer

Prostate cancer diagnosis does not necessarily mean the need for surgery or radiation.  We now know that many prostate cancers are unlikely to ever cause harm, and treatment of these low grade cancers potentially creates more problems than it solves.

Who is it for?

The type of cancer you have is worked out from your prostate biopsy in conjunction with your PSA and any imaging scans.  Broadly speaking, the disease should be of low grade, there should be low volume of disease (i.e not too many cores of prostate involved) and the PSA should not be more than 10.  Many diagnoses of prostate cancer simply aren’t appropriate for a surveillance approach.

How does it work?

The idea is to keep a close eye on the disease, in order to keep open the option of curative treatment down the track.  Active surveillance should not burn any treatment bridges.  So if the disease starts behaving in a more concerning way, you have not lost the opportunity to cure the prostate cancer with surgery or radiation.  In the meantime, you avoid (possibly forever) any potential side-effects of radical treatment.

What’s involved?

Signing up to active surveillance means you have to be comfortable with your diagnosis.  It can be a natural reaction to want to tackle a cancer diagnosis head-on, and active surveillance certainly isn’t for everyone.  But with support, you can take charge of the diagnosis without necessarily going down the path of surgery.

On active surveillance, you will be given a clear plan of how the disease will be monitored.  You will require at least one repeat prostate biopsy, as well as a mixture of surveillance investigations with PSA blood tests, prostate examination and MRI scan of the prostate.