Active surveillance and watchful waiting
Active surveillance and watchful waiting are the most common treatment options recommended when you are first diagnosed with prostate cancer.
However, if you’re not satisfied and want to take action on your prostate cancer, talk to us for a second opinion.
At The Focal Therapy Clinic, our expert team of clinical specialists are experienced with all current prostate cancer treatments. They can help you understand all your options and make a decision that you can be confident in.
Mr Alan Doherty How long should I stay on the Active Surveillance protocol
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Playlist
Active Surveillance for Early Stage Prostate Cancer
SUMMARY
Mr. Alan Doherty (Consultant Urologist, The Focal Therapy Clinic): Active surveillance may not always make senseif the cancer is visible on MRI, it can be targeted with focal therapy instead of waiting for it to progress. Treating early with a minimally invasive approach may help avoid more aggressive treatments later.
This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Read more.
Mr Tim Dudderidge Should I consider focal therapy if I'm on active surveillance
00:01:40
Playlist
Active Surveillance for Early Stage Prostate Cancer
SUMMARY
Mr. Tim Dudderidge (Consultant Urologist, The Focal Therapy Clinic): Active surveillance is for low-risk prostate cancer, but if monitoring causes anxiety, focal therapy may be an option for targeted treatment while avoiding unnecessary interventions. This approach balances effective cancer control with quality of life.
This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Read more.
Mr Marc Laniado Focal Therapy addresses mental health issues after a prostate cancer diagnosis
00:00:51
Playlist
Active Surveillance for Early Stage Prostate Cancer
SUMMARY
Mr. Marc Laniado (Consultant Urologist, The Focal Therapy Clinic): Active surveillance is recommended for slow-growing prostate cancer, but if anxiety over PSA tests disrupts your life, focal therapy may be a better option. It effectively treats cancer with fewer side effects while preserving quality of life.
This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Read more.
Mr Alan Doherty I've been put on active surveillance I hate the idea of having cancer
00:01:15
Playlist
Active Surveillance for Early Stage Prostate Cancer
SUMMARY
Mr. Alan Doherty (Consultant Urologist, The Focal Therapy Clinic): Active surveillance is considered safe, but if cancer is visible on an MRI and can be treated with minimal side effects, why wait? Cancer only worsens over time, so early treatment with focal therapy may be a better option to prevent progression while preserving quality of life.
This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Read more.
Mr Alan Doherty If I'm on active surveillance, how likely is it that I'll need treatment
00:00:44
Playlist
Active Surveillance for Early Stage Prostate Cancer
SUMMARY
Mr. Alan Doherty (Consultant Urologist, The Focal Therapy Clinic): Active surveillance is a common choice, but studies like ProtecT show that 2025% opt for treatment within 2 years due to PSA changes, and 50% receive treatment within 10 years. Understanding the likelihood of progression can help men make informed decisions about early intervention.
This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Read more.
Dr Christos Mikropoulos How often am I tested once I'm put on active surveillance
00:00:26
Playlist
Active Surveillance for Early Stage Prostate Cancer
SUMMARY
Dr. Christos Mikropoulos (Oncologist, The Focal Therapy Clinic): Active surveillance follows European guidelines, involving PSA tests every 36 months, annual MRI scans, and biopsies if MRI changes are detected. This structured approach ensures close monitoring while delaying or avoiding unnecessary treatment.
This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Read more.
Dr Christos Mikropoulos Will I need another biopsy while on Active Surveillance
00:00:14
Playlist
Active Surveillance for Early Stage Prostate Cancer
SUMMARY
Dr. Christos Mikropoulos (Oncologist, The Focal Therapy Clinic): Patients on active surveillance will likely need another biopsy within two years to monitor any changes in their prostate cancer status. Regular PSA tests and MRI scans help track progression and guide treatment decisions when necessary.
This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Read more.
Mr Marc Laniado If I'm on active surveillance or watchful waiting, how likely is it that I'll nee
00:01:47
Playlist
Active Surveillance for Early Stage Prostate Cancer
SUMMARY
Mr. Marc Laniado (Consultant Urologist, The Focal Therapy Clinic): Active surveillance is an option, but delaying treatment may increase risks. Early focal therapy treats a smaller area, preserves healthy tissue, and reduces the likelihood of progression to more invasive treatments like surgery or radiotherapy.
This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Read more.
What is active surveillance for prostate cancer?
00:00:27
Playlist
Active Surveillance for Early Stage Prostate Cancer
SUMMARY
Dr. Christos Mikropoulos (Oncologist, The Focal Therapy Clinic): Active surveillance manages low-risk prostate cancer without immediate treatment, using regular MRI scans, blood tests, and biopsies to monitor for any changes. This approach helps avoid unnecessary interventions while ensuring timely treatment if needed.
This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Read more.
Downsides of active surveillance for prostate cancer
00:00:58
Playlist
Active Surveillance for Early Stage Prostate Cancer
SUMMARY
Mr. Marc Laniado (Consultant Urologist, The Focal Therapy Clinic): Active surveillance requires frequent PSA tests, MRIs, and biopsies, which can have side effects and cause anxiety. Focal therapy removes the tumor, reducing the need for repeated biopsies while maintaining excellent cancer control and preserving quality of life.
This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Read more.
Active surveillance & watchful waiting for prostate cancer: when will I need more?
00:00:59
Playlist
Active Surveillance for Early Stage Prostate Cancer
SUMMARY
Mr. Marc Laniado, Mr. Alan Doherty, Dr. Christos Mikropoulos (The Focal Therapy Clinic): Active surveillance delays treatment, but most men eventually need intervention. Studies show that 2025% opt for treatment within 2 years due to PSA anxiety, and many require treatment within a few years. Considering early focal therapy can help maintain quality of life while effectively managing cancer.
This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Read more.
“Active surveillance may be highly effective in monitoring cancer, but for me, it was doing my head in — constantly worrying, not sleeping properly, and with my mind taking me to some very dark places.”
Perry Letcher
The Focal Therapy Clinic patient
How it works
If your cancer is very early, or growing very slowly, your doctor might suggest active surveillance or watchful waiting.
Active surveillance
Active surveillance involves regular scans and tests to monitor the progression of your cancer, if it’s caught early or looks like it’s growing so slowly you might not need treatment. You will have:
- Regular multiparametric MRIs (mpMRIs), also known as prostate MRIs, every 12-18 months
- PSA blood tests every 3-4 months
Previously, if you were on active surveillance, you would also have regular prostate biopsies. However, advances in MRI technology have reduced the need for this. However, if your cancer changes or pgoresses, you might need a biopsy to diagnose it for definite.
Watchful waiting
Watchful waiting also involves monitoring your cancer, but only using PSA tests and regular GP visits to check your symptoms. You’ll be recommended watchful waiting if:
- You are older and don’t have any symptoms
- You have another medical condition that might make prostate cancer treatment difficult
- You would rather avoid any treatment and its side effects
Suitability
You are most likely to be recommended active surveillance if you have early, or localised, prostate cancer or locally advanced cancer, and you’re older and overall less fit and healthy.
However, if you’re not happy with the risks posed by your prostate cancer, including the anxiety of having a cancer diagnosis, other treatment options could be better for you.
Success rates
Active surveillance has been shown to be safe and effective in reducing treatment for people with early-stage prostate cancer. You have roughly the same chance of living for 10 years after your diagnosis as you do if you choose to have surgery or radiotherapy.
Side effects
If your cancer changes or you experience new side effects, you might need additional tests, such as biopsy. You may also need more radical treatment than focal therapy.
For some people, their cancer diagnosis can cause stress and anxiety, which impacts their overall health. You might decide that you’d prefer to risk an early treatment intervention than your cancer growing whilst you aren’t having treatment.
If you’re on active surveillance or watchful waiting and would like to explore your other treatment options:
contact us today
Any questions?
If you’ve got any questions about your prostate cancer diagnosis or want to know more about HIFU or NanoKnife, don’t hesitate to get in touch with our friendly, knowledgeable team.
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