Active Surveillance

Overview

• Most men with Grade Group 1 prostate cancer never need treatment in their lifetime.
• Modern surveillance uses serial PSA, multiparametric MRI, and targeted re-biopsy to detect any change early.
• Treatment, focal therapy, surgery, or radiation, remains a fully effective option if and when progression is detected.

Symptoms

• By definition, surveillance patients have low-volume, low-grade disease with no urinary or systemic symptoms.
• The decision is driven by biopsy grade, PSA density, MRI findings, and patient preference.

How it is diagnosed

• Baseline multiparametric prostate MRI and MRI-fusion confirmatory biopsy.
• PSA every 6 months and clinical exam annually.
• Repeat MRI at 12–18 months and targeted re-biopsy at 1–3 year intervals.
• Genomic testing of biopsy tissue to refine risk in selected cases.

Treatment options