Prostate cancer differs from many other cancers. About one in eight men will be diagnosed with it, but with early detection and careful monitoring, most men will never die from the disease. In many cases, prostate cancer grows so slowly that treatment may not be needed immediately, and in some cases, not at all.

This is where active surveillance comes in. It is a carefully planned approach that allows doctors to monitor the tumor and treat if and when needed. It’s important to catch prostate cancer early to give you the full range of options, so if you are between 45 and 50, schedule an appointment with your primary care doctor for a prostate cancer screening.

When does prostate cancer require immediate treatment?

Doctors now have better tools than ever to assess how aggressive a prostate tumor may be. PSA levels, Gleason scores, MRI results and biopsy findings all help determine whether a cancer is low-risk or more aggressive. Most prostate cancers fall into the lower-risk category. Tumors that need immediate treatment are less common, tend to grow more quickly and are treated with surgery and/or radiation.

When is active surveillance warranted?

Active surveillance is often the best option for men with low-risk prostate cancer, including many Grade Group 1 and some Grade Group 2 tumors. These cancers usually grow very slowly, so treatment can often be delayed or avoided altogether without affecting long-term health.

Instead of immediate surgery or radiation, active surveillance focuses on careful monitoring. This typically includes regular PSA blood tests, MRI scans and repeat biopsies to watch for signs that the cancer is becoming more aggressive. If the cancer remains stable, the monitoring schedule becomes less frequent over time.

Doctors do not base treatment decisions on a single test. They look at the full picture over time to understand how the tumor is behaving. If the cancer shows signs of becoming more aggressive, treatment can begin while the disease is still confined to the prostate and remains highly treatable.

Avoiding treatment side effects

Surgery and radiation remain the gold-standard treatments for aggressive prostate cancer. While these treatments are highly effective, they can also cause side effects such as urinary leakage, erectile dysfunction, bowel changes or bleeding. For men with low-risk cancer, the potential downsides of treatment may outweigh the benefits.

Active surveillance helps many men avoid or delay side effects while still keeping a close eye on the cancer. During this monitoring period, there are no treatment-related side effects because no surgery or radiation has been performed. The goal is to preserve quality of life without compromising safety.

Will repeat biopsies cause the cancer to spread?

Many patients worry that repeated prostate biopsies could cause the cancer to spread. Fortunately, decades of research and clinical experience show that prostate biopsies do not cause prostate cancer to spread or become more aggressive. If your doctor recommends repeat biopsies as part of active surveillance, you can be confident this is a safe and well-established approach.

Acceptance of active surveillance

Active surveillance has become the preferred standard of care for many men with low-risk prostate cancer. Today, an estimated 60% to 80% of eligible patients choose this approach. Monitoring plans are personalized, so the timing of PSA tests, MRIs and biopsies is tailored to each individual.

Prostate care at Endeavor Health

At Endeavor Health, your care team will recommend a treatment plan tailored to your specific cancer, overall health and personal goals. For many men, that plan may include active surveillance rather than immediate surgery or radiation. A simple PSA test can help detect prostate cancer early, so contact your primary care doctor or schedule a screening to take a proactive step toward protecting your health and future.