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Updated: Aug 14, 2026
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A New Technique for Treating Low-risk Prostate Cancer—Super Active Surveillance
Published on: November 7, 2025
Active surveillance for prostate cancer: for whom?
1University of Toronto, Division of Urology, Sunnybrook & Women's College Health Sciences Centre, 2075 Bayview Avenue # MG 408, Toronto, Ontario M4N 3M5 Canada. laurence.klotz@sw.ca
Summary
Active surveillance using prostate-specific antigen (PSA) doubling time helps manage good-risk prostate cancer. This approach avoids overtreatment for indolent cases while identifying those needing intervention.
Area of Science:
- Urology
- Oncology
- Medical Diagnostics
Background:
- Prostate-specific antigen (PSA) screening leads to overdiagnosis of indolent prostate cancer.
- Good-risk prostate cancer (Gleason score ≤6, PSA <10, T1c-T2a) comprises 50% of new diagnoses and is often slow-growing.
Purpose of the Study:
- To evaluate the utility of PSA doubling time (PSA DT) for stratifying risk in favorable-risk prostate cancer.
- To determine if PSA DT can guide active surveillance and selective intervention strategies.
Main Methods:
- Patients with favorable-risk prostate cancer were managed with active surveillance.
- PSA DT was estimated using at least three PSA measurements over six months.
- Radical intervention was offered for PSA DT ≤3 years; others were monitored with serial PSA and rebiopsies.
Main Results:
- The median PSA DT in 299 patients was 7 years.
- 42% had a PSA DT >10 years, and 20% had a PSA DT >100 years.
- The majority of patients remained under active surveillance.
Conclusions:
- Active surveillance combined with PSA DT-based selective intervention is a practical approach for managing favorable-risk prostate cancer.
- This strategy balances the risks of overtreatment for indolent disease and undertreatment for aggressive disease.
