PSA and other tests to monitor slow-growing prostate cancer
Active surveillance involves monitoring slow-growing prostate cancer while avoiding the side effects of treatment.By Mayo Clinic Staff
In certain situations, men with early-stage prostate cancers may choose to forgo treatment for prostate cancer. Instead, prostate-specific antigen (PSA) tests and other tests and procedures are used to monitor slow-growing prostate cancers in order to avoid treatment side effects in men with a very low risk of cancer progression.
Doctors call this active surveillance. No cancer treatment is provided during active surveillance for prostate cancer. This means medications, radiation and surgery aren't used. Periodic tests are done to check for signs the cancer is growing.
During active surveillance, you'll have regular visits with your doctor to monitor the cancer, usually every few months.
At these visits, your doctor may perform the following tests and procedures:
- PSA blood test. A PSA test measures the amount of PSA in your blood. If your PSA rises, it may indicate cancer growth.
- Digital rectal exam. During a digital rectal exam, your doctor examines your prostate gland by gently inserting a lubricated, gloved finger into your rectum. Your doctor can feel the surface of the prostate and assess if the cancer has grown.
- Ultrasound. If other tests raise concerns, your doctor may use transrectal ultrasound to further evaluate your prostate. A small probe, about the size and shape of a standard cigar, is inserted into your rectum. The probe uses sound waves to create an image of your prostate gland.
- Collection of prostate cells (prostate biopsy). Collecting samples of cells from within your prostate is usually repeated one year after active surveillance begins. Biopsy may be repeated occasionally, as your doctor recommends, to determine how much the cancer has grown and to re-evaluate your Gleason score to see if the cancer remains slow growing.
Many men who choose active surveillance for prostate cancer never undergo prostate cancer treatment. The cancer may never grow, and these men may live out their normal life spans. But some men may choose to treat their prostate cancer if the cancer begins growing or causing signs and symptoms.
If you're considering active surveillance for your prostate cancer, discuss the benefits and risks of this approach with your doctor.
May. 29, 2014
See more In-depth
- Wein AJ, et al. Campbell-Walsh Urology. 10th ed. Philadelphia, Pa.: Saunders Elsevier; 2012. http://www.clinicalkey.com. Accessed Oct. 7, 2013.
- Prostate cancer. Fort Washington, Pa.: National Comprehensive Cancer Network. http://www.nccn.org/professionals/physician_gls/f_guidelines.asp. Accessed Oct. 7, 2013.