Active Surveillance
It is a way of monitoring early stage or slow-growing prostate cancers. It can help avoid or delay radical treatments such as radiotherapy or surgery.
What is active surveillance?
- This is a way of monitoring early stage or slow-growing prostate cancers. It can help avoid or delay treatments such as radiotherapy or surgery.
- If your tests show changes, you will be offered treatment that aims to cure your prostate cancer. You can change your mind at any time. Talk to your doctor if you have any concerns about being on active surveillance.
- Watch our short animation to learn more about active surveillance.
Important things to know
Who can have active surveillance?
Your doctor may recommend active surveillance if:
- Your prostate cancer is contained within your prostate. This is called localised or early-stage prostate cancer.
- Your prostate cancer is not likely to cause you any problems within the next few years.
What are the benefits of active surveillance?
- No treatment side effects.
- If your cancer starts to grow, you may start treatments that aim to cure your cancer. Although this may not be possible if your general health has got worse.
- Active surveillance does not interfere with your everyday life.
- 98 out of 100 people who chose active surveillance were still alive at 10 years.
- This figure is for those with Cambridge Prognostic Group 1, 2 and 3 localised prostate cancer. Ask your doctor or nurse specialist for your grading. Also take a look at our page on the grading and staging of prostate cancer (link will open in a new tab).
- For more accurate and personalised information on the likely risk and benefit from treatment, you can visit the Predict website (this will open an external tab). This site is best used with the support of a healthcare professional.
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"I ended up being Active Surveillance for about 9 years. Overall it was a fairly good journey and like anything around prostate cancer with the regular tests and things you have times of stress but it was manageable".
Simon
Frequently asked questions (FAQs) about active surveillance
What tests will I need to have?
The type of tests and how often you have them may differ between hospitals and doctors. But the most common tests are:
PSA test
You will have PSA tests more often in the first year. About every three-to-four months. They will then go down to about once every six months.
Digital rectal examination
You may also have a DRE every year.
MRI scan
An MRI scan will be offered at 12–18 months.
Prostate biopsies
If your doctor is concerned with any of your test results, you may need to have another MRI and a prostate biopsy.
What happens if my tests show that my cancer has changed?
- If your doctor is concerned that your prostate cancer is changing, they will talk to you about treatments. The treatment choices you have will depend on:
- Your general health
- Your age
- The stage of your cancer.
- If you have other serious health conditions, you may not be able to have surgery or radiotherapy.
Will I have pain during or after treatment?
- As you are not having any active treatments, you should not have any pain. If you need a prostate biopsy, you may feel some discomfort.
Will I need to take time off work during or after my treatment?
- You will need to take time off work for your regular check-ups and tests.
Are there any special instructions I need to know?
Talk to your doctor if:
You start having problems peeing
You get pain in your bones
You feel constantly tired and weak
Being on active surveillance makes you feel anxious or worried.
Will I need to have any other treatments?
No, your doctor will only talk to you about active treatment if your prostate cancer begins to show changes.
What are the main downsides of active surveillance?
- You may need to have more prostate biopsies. These can cause side effects. They may also be uncomfortable or painful for some people.
- If your general health gets worse, you may not be able to have some treatments if you need them e.g. surgery.
- Your cancer may grow more quickly than expected. But there is only a small chance of this happening.
Being on active surveillance can make some people feel anxious. They can worry about their cancer growing. You can always talk about any concerns you have with your doctor or nurse. They can discuss other treatment options with you.
About this information
- This information was updated in December 2024. Date of next review: November 2026.
- References and bibliography available on request.
- If you want to reproduce this content, please see our Reproducing Our Content page (this link will open in a new tab).
What is risk?
- Risk is the chance something bad could happen when we do something. Even simple things such as walking down the stairs can have risks. But we take risks because we think it will be worth it. We need to think about both the benefits and risks of what might happen when we do something.
- You should always ask your healthcare team about both the benefits and risks of any treatment.
- Remember if they tell you about a risk, it doesn‘t mean it will happen to you. They may say one man in ten who has this treatment will have a side effect. But they can‘t tell you if you will be the ‘one’ man who gets this side effect.
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What are the physical risks of active surveillance?
This data is for people with CPG 1, 2 and 3 localised prostate cancer. Click here to learn more about CPG groups (this will open in a new tab).
What are the sexual risks of active surveillance?
This data is for people with CPG 1, 2 and 3 localised prostate cancer. Click here to learn more about CPG groups (this will open in a new tab).
Where does this information come from?
- The information on the risks comes from very large clinical studies. These typically involved thousands of people being watched over many years.
- There may be local data from your area. You can ask your healthcare team if they have this information too.
About this information
- This information was published in March 2023. Date of next review: November 2024.
- References and bibliography available on request.
- If you want to reproduce this content, please see our Reproducing Our Content page.
What is the impact?
- We asked real visitors to the infopool to share their experience of this treatment. They told us how this treatment had impacted their everyday lives in a number of different areas.
- The numbers and images below represent how many people said this treatment had impacted them 'a lot' in each of the different areas.
- For example, imagine it says ‘25 in 100’ underneath ‘physical and social wellbeing’. This means that 25 out of 100 people who shared their experience of this treatment told us it impacted their ‘physical and social wellbeing’ a lot. However, it would also mean that 75 out of 100 people said it had not impacted them a lot.
Physical and social wellbeing
Enjoying activities such as walking or going out to the pub
52 out of 100
Effect on relationships
Ability to make good connections with others
38 out of 100
Sexual activity
Ability to reach sexual arousal, either physically or emotionally
45 out of 100
Sense of self
Knowing who you are and what motivates you
35 out of 100
Wellbeing and quality of life
Feeling good and functioning well in your personal and professional life
52 out of 100
Mental and emotional health
Ability to think clearly, make good decisions, and cope with your emotions
60 out of 100
Fatigue
Feeling of constant physical and/or mental tiredness or weakness
43 out of 100
