Active surveillance for prostate cancer
This is a way of closely monitoring low-risk prostate cancer that isn’t causing any symptoms or problems. The aim is to avoid unnecessary treatment, while looking for changes that mean treatment should start.
Active surveillance may be suggested for prostate cancers with a PSA level under 10 ng/mL, stage T1–2, and Gleason 6 or less (Grade Group 1 and some Grade Group 2). About 70% of Australians with low-risk prostate cancer choose active surveillance.
Active surveillance usually involves PSA tests every 3–6 months; a digital rectal examination every six months; and repeat mpMRI scans and biopsies as advised by your urologist. Ask your doctor how often you need check-ups. If results show the cancer is growing faster or more aggressively, your specialist may suggest starting active treatment.
Choosing active surveillance or watchful waiting avoids treatment side effects, but you may feel anxious about not having active treatment. Talk to your doctors about ways to manage any worries, or call Cancer Council 13 11 20.
Podcast: Making Treatment Decisions
A/Prof Ian Vela, Urologic Oncologist, Princess Alexandra Hospital, Queensland University of Technology, and Urocology, QLD; A/Prof Arun Azad, Medical Oncologist, Urological Cancers, Peter MacCallum Cancer Centre, VIC; A/Prof Nicholas Brook, Consultant Urological Surgeon, Royal Adelaide Hospital and A/Prof Surgery, The University of Adelaide, SA; Peter Greaves, Consumer; Graham Henry, Consumer; Clin Prof Nat Lenzo, Nuclear Physician and Specialist in Internal Medicine, Group Clinical Director, GenesisCare Theranostics, and Notre Dame University Australia, WA; Henry McGregor, Men’s Health Physiotherapist, Adelaide Men’s Health Physio, SA; Jessica Medd, Senior Clinical Psychologist, Department of Urology, Concord Repatriation General Hospital, NSW; Dr Tom Shakespeare, Director, Radiation Oncology, Coffs Harbour, Port Macquarie and Lismore Public Hospitals, NSW; A/Prof David Smith, Senior Research Fellow, Daffodil Centre, Cancer Council NSW; Allison Turner, Prostate Cancer Specialist Nurse (PCFA), Canberra Region Cancer Centre, Canberra Hospital, ACT; Maria Veale, 13 11 20 Consultant, Cancer Council QLD; Michael Walkden, Consumer; Prof Scott Williams, Radiation Oncology Lead, Urology Tumour Stream, Peter MacCallum Cancer Centre, and Professor of Oncology, Sir Peter MacCallum Department of Oncology, The University of Melbourne, VIC.
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