Active Surveillance

What is Active Surveillance?

  • Involves close monitoring of small, slow-growing prostate cancer with relatively normal-looking cells (as determined by your biopsy results);
  • May be appropriate if you are an older man who may be more likely to develop other (age-related) conditions that may have a greater impact on your health;
  • Doesn’t involve invasive procedures
  • Doesn’t involve drugs
  • No side effects
Your prostate cancer will be monitored closely and may involve the following procedures:
 
  • Regular PSA tests and digital rectal exams
  • Monitoring PSA doubling time (this may mean having a PSA test done every 3-6 months)
    • PSA doubling time refers to how long it takes for a man’s level of prostate-specific antigen to double
  • Occasional repeat biopsies
  • Follow-up bone scan and/or CT scan to monitor disease progression
You will be offered more aggressive treatment at the first sign your prostate cancer has progressed or tumour has grown. Your doctor will discuss the advantages and disadvantages of each treatment option.  You should know that active surveillance is not a cure for prostate cancer.  It also carries the risk that your prostate cancer might spread (metastasize).  This is why regular monitoring is so important. 

You may have heard of the term “watchful waiting”.  Watchful waiting involves having no treatment for your prostate cancer.  Rather than treating the prostate cancer, your doctor will wait until you start having symptoms and treat those, usually with medication. The goal of watchful waiting is not to cure your prostate cancer, but treat your symptoms to make you feel better.
 
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