Prostate Cancer: What You Need to Know About Active Surveillance

Active surveillance has become an important approach in prostate cancer care, especially for men diagnosed with low-risk, localized prostate cancer. It offers a way to closely monitor the cancer without immediate aggressive treatment, helping many men avoid unnecessary side effects while maintaining the option for curative treatment if the cancer progresses.

What Is Active Surveillance?

Active surveillance is a strategy of regular monitoring rather than immediate treatment like surgery or radiation. It is designed for men with prostate cancer that is unlikely to grow quickly or spread, often classified as low-risk based on factors such as:

• Prostate-specific antigen (PSA) level less than 10 ng/mL
• Clinical stage T2a or lower
• Gleason score 6 or less
• Limited cancer detected in biopsy cores (e.g., less than 33% of cores involved)

The goal is to safely delay or avoid treatments that can cause side effects, such as urinary and sexual dysfunction, without compromising survival.

How Does Active Surveillance Work?

Men undergoing active surveillance typically receive:

• PSA blood tests every 3 to 6 months to track any increase in prostate cancer activity.
• Digital rectal examinations (DRE) approximately once a year.
• Repeat prostate biopsies within the first 12 to 18 months, then periodically depending on results.
• Imaging tests, such as MRI, may be used to better monitor the prostate.

If tests show signs of cancer progression—such as higher PSA levels, increased Gleason score on biopsy, or changes in prostate examination—curative treatment like surgery or radiation is recommended.

Benefits and Risks of Active Surveillance

Benefits

• Avoids or delays side effects related to surgery or radiation for many years, improving quality of life.
• Allows for treatment only if cancer shows signs of becoming more aggressive.
• Effective for maintaining a low risk of prostate cancer-related death over 10 years in selected patients.

Risks

• Small risk that cancer may progress and possibly spread before treatment is started.
• Anxiety in some men knowing they have untreated cancer and undergoing frequent monitoring.
• Requires compliance with monitoring protocols to ensure safety.

Active Surveillance in Singapore

In Singapore, active surveillance is widely accepted for appropriate patients with low-risk prostate cancer. Guidelines by local experts and oncologists recommend thorough patient education and shared decision-making to choose this approach safely. It is considered a proactive treatment strategy rather than watchful waiting, which is more suitable for patients with limited life expectancy and focuses on symptom control.

Regular men’s health screening in Singapore, including PSA testing and awareness of family history, helps identify candidates for active surveillance early, supporting cancer early detection Singapore efforts.

Conclusion

Active surveillance provides a balanced, patient-centered approach to managing low-risk prostate cancer by combining careful cancer monitoring with the option for timely treatment. For many men, it means preserving quality of life without compromising the chance for cure. If you or someone you know has been diagnosed with prostate cancer, discuss active surveillance as a viable option with your healthcare provider to explore the best plan suited to your risk and lifestyle.

Disclaimer: The content for this article is for informational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always consult your oncologist with any questions regarding a medical condition. Do not disregard medical advice or delay seeking it based on information from this site