Not all prostate cancers need immediate treatment. For carefully selected men with low-risk prostate cancer, active surveillance is a safe, guideline-recommended approach that avoids or delays the side effects of treatment while keeping a careful, structured watch on the cancer. If the cancer shows signs of progression, curative treatment is offered.
TREATMENTS
Active Surveillance for Prostate Cancer
Understanding Active Surveillance
Active surveillance is not simply 'waiting,' it is a structured programme of regular monitoring. It is most appropriate when:
• Prostate cancer has been diagnosed as low-grade (Gleason 6 / ISUP Grade Group 1), or selected cases of favourable ISUP Grade Group 2
• Imaging has identified a small lesion that corresponds with the biopsy findings
• You understand and accept a structured monitoring schedule as for low-risk cancer, the side effects of immediate treatment often outweigh any benefit
Risks and Considerations
All procedures carry risks, which your surgeon will discuss with you in detail. These may include:
• The possibility of progression and later treatment as curative options are preserved by the design
• Repeat biopsies carry minor risks
• Some men find ongoing monitoring causes anxiety. Support and clear information can help, and treatment preferences are always respected
1
Eligibility Assessment
Tumour characteristics (grade group, PSA density, MRI findings, and biopsy core involvement) are reviewed to confirm suitability for active surveillance according to international guidelines.
2
Structured Monitoring
A personalised schedule is established, with regular PSA tests (typically every 3–6 months), imaging and clinical review to ensure the cancer does not change or progress.
3
Progress Imaging +/- Biopsy
A repeat MRI at 12 months is organised, and if required a repeat biopsy may be performed to confirm the cancer has not changed and was not under-graded at diagnosis.
4
Timely Transition to Treatment
If the cancer shows signs of progression (rising PSA, MRI change, or unfavourable biopsy) further tests or curative treatment options will be discussed.
Our Approach
