Changes to your cancer
There’s a chance that your cancer could grow. But the tests used to monitor your cancer aim to find any changes early enough to treat it. And men who have treatment after being on active surveillance can still have treatment that aims to cure the cancer, such as surgery or radiotherapy.
There is a very small chance that the cancer will spread outside your prostate before being picked up, and treatment might not be able to get rid of it completely. This can happen if the tests used in active surveillance miss changes in your cancer. But this isn’t very common.
Sometimes, men diagnosed with low risk prostate cancer actually have a more aggressive cancer that needs treating to stop it spreading outside the prostate. A prostate biopsy only takes small pieces of tissue from the prostate. But prostate cancer grows unevenly, so it’s possible that a biopsy might miss an area of faster-growing cancer. This is uncommon, and you’ll have regular tests to make sure the cancer isn’t growing more quickly than expected.
Research shows active surveillance is a safe way for men with low risk prostate cancer to avoid or delay unnecessary treatment. Men with low risk localised prostate cancer who go on active surveillance have the same chances of living for 10 years or more as men who choose to have treatment with surgery or radiotherapy. It’s important to think about this when deciding whether to have treatment straight away or to go on active surveillance.
Talk to your doctor or nurse if you’re worried about the risk of your cancer growing.
Concerns about not having treatment
Many men with low risk localised prostate cancer choose to go on active surveillance. But active surveillance isn’t for everyone. You might find it difficult not having treatment for prostate cancer, and worry that your cancer will change or spread. Some men on active surveillance decide to have treatment even though there are no signs of any changes in their cancer.
If at any time you decide that you want treatment, talk to your doctor or nurse. You don’t have to stay on active surveillance if you don’t want to.
Changes to your health
There’s a chance that your general health could change, which would make some treatments unsuitable for you if the cancer did grow. For example, if you were to get heart problems, you might not be able to have a radical prostatectomy, as an operation might not be safe for you.
You can lower your risk of many health problems by eating healthily and doing regular exercise. Read more about diet and physical activity.