Prostate cancer active surveillance at Penn Medicine: what to expect
At most hospitals, your initial biopsy determines if active surveillance is the best option for you. The next steps are to get a PSA test and then return in about a year for your next biopsy.
If you choose this approach, active surveillance for prostate cancer guidelines say you should undergo:
- PSA test every three to six months
- Digital rectal exam every six to 12 months
- Biopsy every six to 12 months
At Penn Medicine, our experienced prostate cancer team leads our robust active surveillance program. They create a surveillance plan that considers the full picture of your diagnosis, health and desired quality of life. These plans go above and beyond prostate cancer active surveillance guidelines to include:
Sampling prostate tissue just two millimeters to the right or left of a tumor can affect the accuracy of your diagnosis — and whether active surveillance is best for you.
That’s why we perform confirmatory biopsies. While they are not required by the National Comprehensive Cancer Network, the American Urological Association recommends you have one within two years. If we determine that active surveillance is best for you, you undergo a confirmatory biopsy within three to 12 months of your diagnosis.
We use confirmatory biopsy to confirm the accuracy of the original biopsy. This approach ensures we don’t miss more advanced tumors. Confirmatory biopsies can also give you peace of mind that active surveillance is your best treatment choice.
We use advanced imaging techniques to better see and track prostate cancer. In MRI-fusion biopsy, MRI and ultrasound images are combined to create clearer pictures of the tumor and its location.
Using MRIs to guide biopsies reduces “false-negatives,” the need for repeat biopsies and other sampling errors. Our radiologists specialize in using MRI images to watch prostate cancers.
Personalized surveillance plans
After we analyze your current biopsy and other test results, we schedule your next set of tests based on our findings and your personal risks. This means we may increase or reduce their frequency based your personal health — not just recommended time increments.
This method helps limit the risks involved with active surveillance. It can also help to increase your comfort with this approach.