Prostate Cancer Surveillance Is Safe With Continued Monitoring

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Men with low-risk prostate cancer can usually safely forego treatment as long as they continue to monitor their disease with their clinicians, an expert said.

While patients with prostate cancer do not always need to undergo a biopsy, it is essential that they adhere to follow-up care with their providers, explained Dr. Eric Li, a urology resident at the Northwestern University Feinberg School of Medicine in Chicago.

In December 2021, active surveillance, which is when a patient is not treated but is monitored by their health care team, became the National Comprehensive Cancer Network (NCCN’s) preferred option for men with low-risk prostate cancer. More recently, at the 2023 American Urological Association’s 2023 conference, Li presented research on factors that may predict a patient’s need to undergo a repeat MRI and then biopsy.

Li and his team found that factors such as prostate-specific antigen (PSA) kinetics, which is the rate of PSA change over time, and prostate health index kinetics were predictive of the need for a repeat MRI or biopsy for patients who are undergoing active surveillance for their disease.

The study findings also showed that the rate of clinically significant prostate cancer — meaning disease that is aggressive and typically requires immediate treatment — was only 2%.

READ MORE: Long-Term Prostate Cancer Outcomes May Not Differ by Treatment Type

“So overall, it’s quite safe to monitor these patients, but we just need to make sure that they follow up,” Li said in an interview with CURE®’s sister publication, Urology Times®.


If someone does not undergo a biopsy, one of the important things is that we still need to keep following them. So, they're not quite out of the woods yet. Actually, one of the projects that I'm presenting tomorrow looks at the patients who were not biopsied in this group and what happened to them over time. And we found that things like the PSA kinetics, as well as the prostate health index kinetics were predictive of undergoing a repeat MRI and then some of those patients also proceeded to biopsy.

But we actually found that the rate of subsequent cancer detection with almost two years of follow-up was low, at 2%. So overall, it's quite safe to monitor these patients, but we just need to make sure that they follow up.

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