Active Surveillance for Prostate Cancer
Active surveillance is a treatment strategy used for men with low-risk or some favorable intermediate-risk prostate cancers. Instead of treating the cancer right away with surgery or radiation, doctors monitor it closely to make sure it remains slow-growing.
It’s a safe and widely accepted approach that helps many men avoid or delay the side effects of treatment—such as urinary, sexual, or bowel changes—without compromising long-term outcomes.
Who Is It For?
Active surveillance is typically recommended for men with:
Low-risk prostate cancer
(Gleason Grade Group 1 / Gleason 6)Very low PSA levels or slow PSA growth
Small or limited disease on biopsy
No symptoms from the cancer
Some men with favorable intermediate-risk disease may also be candidates, depending on age, overall health, tumour volume, and biopsy findings.
How Active Surveillance Works
Your healthcare team monitors the cancer through a structured plan that usually includes:
1. PSA Tests
Every 3–6 months to watch for rising trends.
2. Digital Rectal Exam (DRE)
Typically yearly.
3. MRI Scans
Increasingly used to track suspicious areas and guide biopsies.
4. Repeat Biopsies
Often within the first year, then periodically.
(Confirm the cancer’s risk level and detect any changes early.)
5. Switching to Treatment if Needed
If tests show the cancer is growing or becoming more aggressive, you can transition to surgery or radiation while still within the window of cure.
Benefits of Active Surveillance
Avoids or delays treatment side effects
Maintains quality of life
Allows time to make informed decisions
Safe for the right patients — most low-risk cancers grow very slowly
Studies show that men on active surveillance have excellent long-term survival, and most will never require treatment.
Risks or Considerations
Requires regular follow-up
Anxiety or stress about “living with cancer”
Small chance the cancer could grow between checkups
Repeat biopsies can be uncomfortable and carry minor risks
Most men find that being monitored closely — and having a clear plan — helps ease anxiety.
The Role of Support Groups
Many men on active surveillance say that talking to others in the same situation brings clarity and peace of mind. Groups like PROSTAID Calgary offer:
Real-life experience from men who’ve been there
Education from physicians and specialists
Emotional support for both patients and families