Not every cancer needs immediate treatment. Active surveillance is a planned strategy of watching a low-risk cancer with scheduled tests — for prostate cancer, that means periodic PSA blood tests, exams, imaging (MRI) and repeat biopsies — and starting treatment only if it shows signs of growing or becoming more aggressive. It is a standard, guideline-recommended option for many low-risk prostate cancers and is also used for some small kidney tumors, certain thyroid cancers, some low-grade lymphomas, and other indolent cancers. “Watchful waiting” is a related but less intensive approach, often used in older or frailer patients, focused on treating symptoms if they arise rather than aiming for cure. The goal is to avoid overtreatment while not missing the window to treat if needed.
The care team sets a monitoring schedule — for example, regular blood tests, imaging, exams and sometimes repeat biopsies — with clear thresholds that would prompt a switch to active treatment. The patient stays in the driver’s seat, and treatment remains fully available if the cancer changes.
No treatment side effects while on surveillance, in exchange for ongoing testing and follow-up. Some people feel anxiety knowing a cancer is present; others prefer avoiding treatment risks. Plans are revisited over time.