• UPNT clinics will open at a delayed time at 10 AM on 11/11-23 Secondary to the ice storm. we will continue to update on the website as conditions may change.
  • UPNT clinics will open at a delayed time at 10 AM on 11/11-23 Secondary to the ice storm. we will continue to update on the website as conditions may change.
  • UPNT clinics will open at a delayed time at 10 AM on 11/11-23 Secondary to the ice storm. we will continue to update on the website as conditions may change.
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Active Surveillance for Prostate Cancer

A Proven Strategy for Managing Low-Risk Prostate Cancer
At Urology Partners of North Texas (UPNT), research has shown that certain prostate cancers—particularly low-risk cancers—do not require immediate treatment. Instead, Active Surveillance is often the best option, allowing men to avoid unnecessary procedures while carefully monitoring the cancer over time.
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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
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Why Choose Active Surveillance?

Some prostate cancers grow so slowly that they may never cause serious health problems. For many men, especially those with Gleason 6 prostate cancer, immediate treatment isn’t necessary. Studies involving over 20,000 men with Gleason 6 cancer found no cases of distant metastasis beyond the local pelvic area.

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.

Multiparametric MRI: A Critical Tool for Active Surveillance

Multiparametric MRI (mpMRI)

is a vital imaging tool that provides a detailed view of the prostate and monitors cancer progression over time.
  • 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.

Understanding Gleason Scores

The Gleason score is used to determine how aggressive prostate cancer is under a microscope. This score helps decide if Active Surveillance is a safe and effective option.

Gleason Score

Meaning

Risk of Spreading?

Recommended Approach

Gleason 6

Slow-growing, confined to prostate
Rare, stays in local area
Active Surveillance

Gleason 7 (3+4, Low Volume)

Mostly Gleason 3, small Gleason 4
Low but not zero
Possible Active Surveillance if molecular tests confirm low risk

Gleason 7 (4+3 or High Volume 3+4)

Mostly Gleason 4, more aggressiveSlow-growing, confined to prostate

Moderate risk
Treatment recommended

Gleason 8–10

High-risk, aggressive cancer
High risk of spreading
Immediate treatment

Key Point: While most men with Gleason 7 need treatment, some low-volume 3+4 cases may qualify for Active Surveillance—but only if molecular testing and MRI confirm low-risk disease.

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

Gene activity linked to tumor aggressiveness
Predicts if Active Surveillance is a safe option

Decipher Prostate Test

Genetic mutations in cancer cells
Helps decide if monitoring or treatment is best

Prolaris Test

Cell division speed in tumor tissue
Estimates how quickly cancer may progress

For men with low-volume Gleason 7 (3+4), molecular markers can confirm whether Active Surveillance is a safe option.

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
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Why Choose UPNT for Active Surveillance?

  • Comprehensive Approach
We combine advanced pathology, molecular testing, and imaging to create personalized monitoring plans.
  • Experienced Urology Specialists
Our team has extensive experience managing prostate cancer with Active Surveillance.
  • Cutting-Edge Technology
Access to the latest MRI technology and genomic testing.
  • Patient-Centered Care
We prioritize quality of life and long-term health, ensuring every patient receives individualized care.
The procedure typically takes 2–3 hours, and most patients stay in the hospital for 1–2 nights.

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).

The goal is to intervene early if cancer shows signs of progression—before it becomes metastatic.

Frequently Asked Questions (FAQs)

1. 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.
Yes, some low-volume Gleason 7 (3+4) cases may still qualify if genetic testing and MRI confirm low risk. However, higher-volume 3+4 and 4+3 cases usually require treatment.
Once prostate cancer spreads beyond the prostate, it is much harder to treat and may no longer be curable. Catching it early is essential.
Most remain stable for years, but about 20–30% of men on Active Surveillance may need treatment for Gleason 7+ cancer.
Still have questions?
Call our office today

Schedule a Consultation to See if Active Surveillance is Right for You

Not all prostate cancers need immediate treatment—find out if Active Surveillance is right for you.
  • Serving Arlington, Fort Worth, Mansfield, and North Texas
Call Now
Book Online

CONTACT

866-367-8768
  • 5005 S. Cooper St. Suite 250 Arlington, TX 76017
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This Website and associated Web Properties is intended to provide our users with educational information only and IS ONLY PROVIDED AS A CONVENIENCE, is not to be considered as a valid resource for information or contact or communication with a Urology Partners of North Texas, PLLC physician, our practice or its staff. This site and all of its information is NOT INTENDED TO OFFER MEDICAL ADVICE to any specific person. This site may provide you with information or facilitate your communication with a health care provider, but is not a substitute for the professional judgment of a health care provider. Call your health care provider or dial “911” immediately if you think you have a medical emergency. Always seek the advice of your physician or other qualified health care provider prior to starting any new treatment, or if you have any questions regarding symptoms or a medical condition.

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