Active surveillance

Monitoring your cancer

Sometimes, prostate cancer does not require immediate treatment. This is because we know that not all such cancers progress to become life-threatening, and depending on your age, general health and other factors, the risks and side-effects of treatment may outweigh the benefits. So with very small tumours it is becoming increasingly common to monitor the situation carefully, and see how the disease progresses over time. This is not the same as “doing nothing”. On the contrary, it is vital that we keep track of you and act promptly if necessary. That is why this type of care is called “active surveillance”. Properly followed, this routine means that the chances of the cancer progressing to an incurable stage are remote.

Who is it suitable for?

Patients with small areas of low-grade prostate cancer are at low risk of progression and as such are good candidates for active surveillance rather than surgery or radiotherapy. These individuals are usually defined as having a PSA of less than 10ng/ml and biopsies revealing Gleason pattern 6 or less, adenocarcinoma (cancer) in less than 10% of one or two cores only and an MRI confirming no spread outside the prostate.

How does it work?

Active surveillance involves monitoring the cancer by PSA testing, repeat MRI scanning and further biopsy as necessary. The biopsy may need to be done under light general anaesthetic as a day case in hospital, so that many more samples can be taken than with local anaesthetic. You should have your PSA checked every three months, as any rise may mean we need to move on to further investigation. At The Prostate Centre, we prefer to call this system “Pro-active surveillance” as it gives us the opportunity to go the extra mile and keep a check on your general health as well. We can monitor your risk of cardiovascular disease as well as of other conditions such as colon cancer and thyroid dysfunction, we can help you plan dietary changes and encourage a weight-loss, fitness and exercise regime.

Where is it done?

You can come to The Prostate Centre for your regular PSA checks, or if you live too far away you can send us the results of tests done locally. Further diagnosis is handled by The Prostate Centre.

How much does it cost?

This regime incurs the costs of pathology tests, scanning and consultations as required. Sometimes, insurance companies do not consider this path of action as eligible for benefit because it does not involve a specific one-off treatment (or course of treatments) for an acute condition. It is advisable to check with your insurer if you decide on active surveillance.