Active Surveillance for Prostate Cancer

Low-Risk Prostate Cancer Care

Beth Israel Deaconess Medical Center (BIDMC) prostate specialists have decades of experience in effectively diagnosing and treating prostate cancer.

More men with early-stage prostate cancer are choosing to defer treatment. Instead of active treatment, they’re opting to monitor the status of their cancer by having regular physical exams and screening tests. The results help their prostate cancer specialist determine if they’re safe to continue delaying treatment or if it’s time to start treating the cancer.

Many men opt for active surveillance because they can safely delay bothersome side effects of prostate cancer treatment, including sexual, urinary and bowel problems.

Candidates for Active Surveillance

Generally, you may be a good candidate for active surveillance if you have low-grade prostate cancer. This means:

• Your prostate specialist cannot feel the tumor during a digital rectal exam (DRE).
• Your PSA level is under 10 ng/mL.
• The pathologist found cancer on just one or two biopsy samples. None of the samples have more than 50% cancer.
• Your cancer grade on the Gleason score is not higher than 6 (out of a possible 10).

What To Expect with Active Surveillance

Active surveillance usually involves having these tests every six months:

• Blood tests to measure the levels of prostate-specific antigen (PSA), a protein linked to prostate cancer
• Digital rectal exam (DRE)

In addition, you’ll have a prostate biopsy using transrectal ultrasound every year or two. This monitors how much cancer is in the gland and how aggressive it might be. If changes occur, you and your prostate specialist may decide to move forward with treatment.

While in active surveillance, many men choose to make positive lifestyle changes that can improve their overall health. These changes may include:

• Eating a healthy diet
• Getting physical activity on a regular basis
• Taking supplements