Why Not Active Surveillance?


I have been told that I need radical prostate surgery.

My details are as follows:

  • Age = 60
  • PI RAD = 3 
  • Tumor = T2
  • Gleeson = 3 + 4
  • Grade Group 2

I asked if I am a candidate for Active Surveillance (AS) but I am told that I am not. 

My questions are:

  1. Can you think why I wouldn't be suitable for AS?
  2. Can I insist on entering an AS programme?

Kind Regards,

Slight smile

  • Hello STP,

    Thanks for getting in touch with us and welcome to our online community.  My name is Linda and I’m one of the Cancer Information Nurses on the Macmillan Support Line.

    It’s difficult for us to be specific about why you would not be suitable for Active Surveillance. I wonder if your consultant gave you any reasons for this and their recommendation of radical prostate surgery.  

    They may be recommending surgery because you are younger and are fit enough for it. I would encourage you to clarify this with your consultant.

    You may find this information on Active Surveillance from Prostate Cancer UK useful. It does suggest that men with a Cambridge Prognostic Group (CPG) of 2 may be suitable.

    You can ask for Active Surveillance but you may need to consider getting a 2nd opinion if your consultant is not in agreement with you.

    I hope this information is useful. Please don’t hesitate to get back in contact by email, webchat or phone, if you need further information or support.

    The Macmillan Support Line offers practical, clinical, financial and emotional support. You can call us free from landlines and from most mobile phone networks on 0808 808 00 00, 7 days a week, 8am – 8pm.

    Best Wishes

    Linda J. Cancer Information Nurse Specialist.

    Ref LJ/KS


  • Many thanks for the clear explanation and good advice Linda.

    Kind Regards

    Slight smile