Tests and Procedures

Active surveillance for prostate cancer

Overview Why it's done Risks What you can expect Results

What you can expect

During active surveillance, you'll have regular visits with your doctor to monitor the cancer, usually every few months.

At these visits, your doctor may perform the following tests and procedures:

  • Digital rectal exam. During a digital rectal exam, your doctor examines your prostate gland by gently inserting a lubricated, gloved finger into your rectum. Your doctor can feel the surface of the prostate and assess whether the cancer has grown.
  • PSA blood test. A PSA test measures the amount of prostate-specific antigen (PSA) in your blood. If your PSA rises, it may indicate cancer growth.
  • Ultrasound or magnetic resonance imaging (MRI). If other tests raise concerns, your doctor may use transrectal ultrasound or MRI to further evaluate your prostate. During an ultrasound, a small probe, about the size and shape of a cigar, is inserted into your rectum. The probe uses sound waves to create an image of your prostate gland. During an MRI, you lie inside a machine that uses radio waves to create cross-sectional images of your prostate.
  • Collection of prostate cells (prostate biopsy). Collecting samples of cells from within your prostate is usually recommended one year after active surveillance begins. Biopsy may be repeated occasionally, as your doctor recommends, to determine how much the cancer has grown and to re-evaluate your Gleason score to see if the cancer remains slow growing.

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