Active surveillance and watchful waiting
Not all prostate cancers need to be treated immediately. For some men it may be possible to monitor their cancer and only start treatment if it progresses.
There are two approaches to monitoring prostate cancer. These are called active surveillance and watchful waiting.
Prostate cancer often grows slowly. If the cancer is localised, slow growing, and not causing any symptoms, active surveillance may be offered.
This is where treatment isn’t started straight away. The man is reviewed and has tests every 3 to 6 months. If the cancer starts to grow or cause symptoms, then treatment is started. The aim of active surveillance is to avoid unnecessary treatments.
This is similar to active surveillance, but there are fewer tests. Watchful waiting is used when the person:
- has no symptoms
- has other health problems
- is elderly.
The doctor still does regular reviews. If symptoms develop then treatment may be started. When treatment is given the aim is usually to control the symptoms.
Prostate specific antigen (PSA) test
Prostate specific antigen (PSA) is a protein made by cells in the prostate. It can be measured using a blood test.
PSA levels can be raised in a number of situations, which include:
- prostate cancer
- an infection in the prostate
- recent sexual activity
- benign prostatic hypertrophy or enlarged prostate
- urinary tract infection.
The PSA blood test alone isn’t a reliable way to detect prostate cancer.
It can be used together with digital rectal examination (DRE) to monitor men with a family history of prostate cancer.
The PSA test can also be used as part of active surveillance for some men with prostate cancer.