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Active Surveillance for Prostate Cancer

Strategy of monitoring low-risk prostate cancer instead of immediate treatment.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Üroloji department. Book Appointment →

What is Active Surveillance for Prostate Cancer?

Active surveillance is a planned monitoring strategy used in carefully selected patients with low-risk localised prostate cancer, in whom definitive treatment (radical prostatectomy or radiotherapy) is deferred until evidence of disease progression. This approach aims to avoid the overtreatment-related side effects of treatment-related morbidity.

Active surveillance differs from watchful waiting; it involves regular PSA testing, multiparametric prostate MRI, digital rectal examination and confirmatory/follow-up biopsies. It is most commonly applied to Gleason 6 (Grade Group 1) tumours and selected favourable-intermediate cases (Gleason 3+4=7).

Long-term studies (e.g. ProtecT, Toronto Active Surveillance) have shown that prostate cancer-specific mortality remains very low; approximately 50% of patients require definitive treatment within 10-15 years. Patient compliance and structured follow-up are critical for success.

Symptoms

Low-risk prostate cancer
Gleason score 6 (Grade Group 1)
PSA below 10 ng/mL
Clinical T1c-T2a stage
Limited tumour volume on biopsy
Asymptomatic disease

Risk Factors

Advanced age and short life expectancy
Significant comorbidity
High morbidity risk from treatment
Patient preference
Family history (relative contraindication)

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • After low-risk prostate cancer diagnosis
  • When choosing between treatment options
  • Rising PSA during surveillance
  • New lesion on follow-up MRI
  • Grade increase on follow-up biopsy
  • If new urinary symptoms develop

Treatment Methods

01
PSA every 3-6 months
02
Multiparametric prostate MRI annually
03
Digital rectal examination every 6-12 months
04
Confirmatory biopsy at 1-2 years
05
Follow-up biopsy every 2-5 years
06
Triggering definitive treatment upon progression
07
Patient education and shared decision-making

Which Department to Visit?

You can visit our Üroloji department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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You can make an appointment with our specialists or contact us for your concerns.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.