Active Surveillance for Prostate Cancer
A Proven Strategy for Managing Low-Risk Prostate Cancer
Our team of expert urologists uses a combination of advanced imaging, genetic testing, and regular follow-ups to ensure that your cancer remains under control and that treatment is initiated only if necessary.
- Serving Arlington, Fort Worth, Mansfield, and North Texas
Why Choose Active Surveillance?
Here’s why Active Surveillance is essential:
- Biopsies only sample part of the prostate, meaning more aggressive cancer could still be present.
- Low-volume Gleason 7 cancers (3+4) may still qualify for Active Surveillance if molecular testing confirms low risk.
- The goal is to intervene early if cancer progresses while preserving quality of life.
At UPNT, our urologists use:
- Expert Pathology Review – Ensuring an accurate Gleason score.
- Molecular Testing – Identifying the genetic behavior of your cancer.
- Multiparametric MRI (mpMRI) – High-resolution imaging to monitor changes.
- Regular PSA Testing & Physical Exams – Tracking prostate health every 6 months to 1 year.
Understanding Gleason Scores
Gleason Score
Meaning
Risk of Spreading?
Recommended Approach
Gleason 6
Gleason 7 (3+4, Low Volume)
Gleason 7 (4+3 or High Volume 3+4)
Gleason 8–10
How Molecular Testing Helps Determine Low-Risk Cancer
Since biopsies sample only part of the prostate, genetic testing provides an essential second layer of information to confirm if cancer is truly low-risk.
Molecular Marker
What It Measures
Why It Matters
Oncotype DX Genomic Prostate Score
Decipher Prostate Test
Prolaris Test
Multiparametric MRI: A Critical Tool for Active Surveillance
- Offers a real-time, 3D view of the prostate.
- Detects tumors that may have been missed on a biopsy.
- Tracks whether cancer is changing or growing over time.
- Works alongside PSA monitoring for a comprehensive surveillance plan.
How Does Active Surveillance Work?
Active Surveillance is a structured monitoring plan that reduces the risk of overtreatment while ensuring cancer is closely watched.
Here’s what the typical plan looks like:
- Every 6 Months – PSA Blood Test
- Every Year – Physical Exam
- Every 1–2 Years – MRI Scan & Possible Repeat Biopsy
- At Any Sign of Change – Immediate Follow-Up & Adjustments
When Does Active Surveillance Switch to Treatment?
Active Surveillance is designed to catch changes early. If any of the following occur, treatment may be recommended:
- Rising PSA levels beyond normal fluctuations.
- MRI shows tumor growth or changes in PI-RADS score.
- A follow-up biopsy detects higher-grade cancer (Gleason 7+ with increased risk factors).
Why Choose UPNT for Active Surveillance?
- Comprehensive Approach
We combine advanced pathology, molecular testing, and imaging to create personalized monitoring plans.
- Experienced Urology Specialists
- Cutting-Edge Technology
- Patient-Centered Care
Frequently Asked Questions (FAQs)
Do Gleason 6 cancers ever spread?
No. Gleason 6 prostate cancer rarely, if ever, spreads beyond the local area (prostate and pelvic region). Studies of over 20,000 men found no cases of distant metastasis.
Can some Gleason 7 cancers qualify for Active Surveillance?
Why treat prostate cancer before it becomes metastatic?
If I have Gleason 6 prostate cancer, do I need to treat it right away?
Not always. Gleason 6 is considered low-risk and often grows slowly, which is why many men choose active surveillance—a safe, monitored approach using regular PSA testing, MRI scans, and occasional biopsies.
That said, 30–45% of men initially diagnosed with Gleason 6 prostate cancer are later found to have Gleason 7 or higher within the first 10 years. This is why close monitoring is critical: if the cancer becomes more aggressive, treatment can start right away.
Schedule a Consultation to See if Active Surveillance is Right for You
- Serving Arlington, Fort Worth, Mansfield, and North Texas