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Active Surveillance for Prostate Cancer how safe is it?

Doctor monitoring prostate cancer

Prostate cancer is a common type of cancer that affects the prostate gland in men. It is often detected through a prostate-specific antigen (PSA) blood test or digital rectal exam (DRE). When prostate cancer is detected, treatment options may include surgery, radiation therapy, or hormone therapy. However, for some men with low-risk prostate cancer, active surveillance may be a suitable option.

Active surveillance is a form of monitoring that involves regularly checking the cancer to ensure that it is not growing or spreading. This approach is often recommended for men with low-risk prostate cancer, as studies have shown that many men with low-risk prostate cancer may not require immediate treatment.

During active surveillance, patients will undergo regular PSA blood tests and prostate biopsies to monitor the cancer. The frequency of these tests will depend on the patient’s individual case, but they may be done every 3-6 months initially and then less frequently once stability is established. Additionally, patients may be advised to make lifestyle changes such as maintaining a healthy diet and exercising regularly.

The benefits of active surveillance for prostate cancer include avoiding potential side effects of treatment, such as urinary incontinence and erectile dysfunction. It can also reduce the risk of over-treatment, which can lead to unnecessary interventions and treatment-related complications.

How safe is Active Surveillance for Prostate Cancer?

One of the main concerns for men considering active surveillance is the safety of this approach.

Overall, active surveillance is considered to be a safe approach for monitoring low-risk prostate cancer. In fact, several studies have shown that active surveillance is associated with low rates of disease progression and cancer-related death. One study conducted by the Prostate Cancer Research International Active Surveillance (PRIAS) study group found that after 10 years of follow-up, only 15% of men on active surveillance experienced disease progression.

It is important to note that active surveillance is not suitable for all cases of prostate cancer, and it is important to discuss all treatment options with a healthcare provider. Factors that may indicate the need for immediate treatment include the size and location of the cancer, the patient’s age and overall health, and the presence of certain genetic mutations.


Active surveillance may be a suitable option for some men with low-risk prostate cancer. This approach involves regular monitoring to ensure that the cancer is not growing or spreading and can help to avoid potential side effects of treatment. If you are considering active surveillance for prostate cancer, it is important to discuss this option with a healthcare provider to determine if it is the best course of action for your individual case.

Author: Mr Neil A Haldar MBBS MD FRCS UROL

Consultant Urological Surgeon

The Pelvic Specialists

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