Patients diagnosed with Stage 1 Prostate Cancer will usually have had a PSA level test which is abnormal, followed by an mpMRI scan that yields a PIRADS score of 1 or 2.
Early Cancer is present in the Prostate Gland, but it is most likely regarded as “indolent” and not in requirement of any immediate treatment.
If you are in this category you will remain in the system and continue to have regular PSA tests, typically at 6 month intervals, and further mpMRI scans as appropriate to the PSA results – perhaps annually.
This is called Active Surveillance.
Treatment would then be considered if the tumour began to grow more rapidly and move to higher PIRADS scoring, now requiring targeted biopsy. Indeed, mpMRI scanning has more resolution than the previous biopsy techniques alone, and even if you are given a staging of T1c, rather than T2a, you would likely move to a treatment regime similar to that described as “Stage 2”.
Remember that neither the PSA test, nor the mpMRI scan is invasive, and the MRI scan is X-ray free.
You may want to review the PSA Test page and the mpMRI scan page to refresh your knowledge of these tests.
Dr Mark Scholz discusses the history of how Active Surveillance was discovered.