Introduction
Active surveillance is a management strategy for some low-risk prostate cancers: the cancer is monitored closely instead of immediate surgery or radiation. The aim is to avoid unnecessary treatment side effects while acting promptly if the disease progresses.
It is not "doing nothing." Scheduled PSA tests, examinations, MRI, and repeat biopsies are core parts of the plan. Not everyone is eligible—grade, stage, PSA, age, and overall health guide the decision with a urologist.
Why it is done / when it is considered
Active Surveillance for Prostate Cancer is commonly discussed in situations such as:
- Very low-risk or slow-growing prostate cancer where immediate treatment may be unnecessary
- Desire to defer treatment side effects such as incontinence or erectile dysfunction when safe
- Older age or other illnesses where watchful waiting is reasonable
- Patient commitment to regular follow-up and testing
How the procedure is done
- PSA blood tests and clinical exams at set intervals
- Multiparametric MRI when indicated
- Repeat prostate biopsy on schedule or if suspicion rises
- Transition to active treatment if grade, volume, or PSA trend worsens
Preparation
- Keep prior biopsy, PSA, and imaging reports organized
- Do not miss follow-up appointments—they are the foundation of safety
- Tell your doctor about medicines or supplements that affect PSA
- Report new urinary symptoms, blood in urine, bone pain, or weakness promptly
Risks and possible complications
Risks differ by procedure. Your age, other illnesses, and anaesthesia plan change the picture—your care team will explain what applies to you.
- Missed follow-up may delay detection of progression
- Repeat biopsies carry discomfort and small infection risk
- Some cancers may behave more aggressively than expected
- Psychological stress from living with untreated cancer
Recovery
- Daily life usually continues normally—this is not surgery
- Temporary blood in urine or semen may occur after biopsy; rest as advised
- Healthy lifestyle supports overall outcomes
Aftercare and follow-up
- Review each visit with your urologist before changing strategy
- Calendar all future test dates
- Do not switch to surgery or radiation without shared decision-making
- Contact the team early for rising PSA or new symptoms
Frequently asked questions
Is active surveillance the same as no treatment?
No. Structured monitoring is treatment planning; curative therapy starts if criteria for progression are met.
Does a slightly higher PSA always mean surgery?
Decisions use trends, MRI, and biopsy together—not a single number.
Can I choose active treatment later?
Yes. You can discuss surgery or radiation at any time if your preferences change.
Important caution
This article is general health information. It is not personal medical advice, a surgery recommendation, or a cost promise.
Decide on need, alternatives, risks, and cost with your doctor and hospital. If you have emergency symptoms, go to hospital without delay.