What are the risks of active surveillance for prostate cancer?
There is a risk that the prostate cancer will grow during active surveillance. That's why it's important to follow your doctor's schedule of tests and exams. It will help your doctor find out right away if the cancer is growing. Then it can be treated in the early stages, when treatment is most successful.
Active surveillance or observation for prostate cancer
Active surveillance and observation are wait-and-see approaches to treatment for prostate cancer. They let you avoid or postpone treatments like surgery and radiation that can cause serious side effects.
- Active surveillance. This means that you’ll have regular checkups and tests but you won’t have treatment unless the cancer gets worse. This may be an option if cancer hasn't spread outside the prostate (localized prostate cancer). In this case, you may never need treatment. Or you may be able to delay treatment and its side effects until tests show that the cancer is growing more quickly.
- Observation. This means that you'll have regular visits with your doctor but fewer tests. The focus is on treating any symptoms that bother you rather than treating the cancer. This may be a good choice if you are too ill to have (or don’t want to have) aggressive treatment, such as surgery.
With either option, you can choose to start treatment at any time.
When is active surveillance an option for prostate cancer?
Active surveillance is an option for some people who have slow-growing cancer that hasn't spread outside the prostate (localized). With active surveillance, you'll have regular checkups and tests. You won't have treatment unless tests show the cancer is growing. Some people will never need treatment.
It may seem odd to have cancer and not have treatment for it. But many people choose active surveillance because:
- Most prostate cancer grows very slowly. It's possible to have prostate cancer for years and not have any symptoms.
- Prostate cancer treatments have serious side effects, such as bladder and erection problems. Active surveillance lets people avoid or delay treatment and its side effects.
If test results, including the Gleason score from your prostate biopsy, show this is an option for you, talk to your doctor. To help you make your decision, discuss:
- The risk that the cancer will grow.
- Your overall health and how long you're likely to live (life expectancy).
- Your preferences.
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