Sample report — newly diagnosed, low-risk, considering active surveillance

This report is educational only. It is not a diagnosis, a treatment plan, or a second opinion, and it is not a replacement for your cancer care team. Do not start, stop, or change any medicine, supplement, or treatment based on this report. Talk with your urologist, oncologist, or primary care clinician before you act on anything here.

If you have any of the following, stop reading and get emergency care now: sudden new weakness or numbness in your legs, loss of bowel or bladder control, inability to urinate at all, uncontrolled bleeding, severe chest pain, or trouble breathing. In the United States, call 911.

This is a sample report shown for illustration. The person, PSA values, and details below are fictional.

You were recently diagnosed with prostate cancer that appears to be confined to the prostate (localized). Your biopsy was read as Gleason 3+3=6, which is called Grade Group 1 — the lowest-risk category. Your PSA moved from 5.8 to 6.1 over about a month; a single small change like this is usually not meaningful on its own and is best interpreted as a trend across several readings.

You told us your top priorities are keeping your quality of life, protecting sexual function, and protecting urinary control. You are open to active surveillance and want to understand what monitoring really looks like, and when treatment would move from 'watch' to 'act.'

Grade Group 1 prostate cancer grows slowly. In large studies, men with Grade Group 1 disease who chose active surveillance had the same 10- and 15-year prostate-cancer survival as men who had immediate surgery or radiation, while avoiding — or delaying by years — the side effects of treatment. Active surveillance is not 'doing nothing.' It is a structured monitoring plan designed to catch any change early enough to still treat with intent to cure.

• Active surveillance with a defined monitoring schedule (PSA every 6 months, digital rectal exam yearly, MRI at defined intervals, and a confirmatory biopsy — often within 6–18 months of diagnosis).
• Definitive treatment now with radical prostatectomy (surgery to remove the prostate).
• Definitive treatment now with radiation therapy (external beam or brachytherapy).

For Grade Group 1 disease, major U.S. and international guidelines identify active surveillance as the preferred initial approach for most patients. Treatment can still be offered later if surveillance shows meaningful change.

Active surveillance: preserves urinary and sexual function in the near term; requires repeated tests including at least one more biopsy; carries a small risk that a higher-grade cancer is missed on the first biopsy and found later.

Surgery: one-time procedure with clear pathology; higher near-term risk of urinary leakage (usually improves over months) and erectile changes (often long-lasting, partly age-dependent).

Radiation: no surgery and no anesthesia; urinary and bowel irritation during and after treatment; erectile changes often appear gradually over 1–2 years; small long-term risk of secondary bladder or rectal effects.

A typical active-surveillance protocol includes: - PSA test every 6 months. - Digital rectal exam every 12 months. - Prostate MRI at diagnosis and at defined intervals (often every 12–24 months, or sooner if PSA rises). - A confirmatory biopsy within about 6–18 months of the first biopsy, then repeat biopsies driven by PSA trend, MRI, and clinical judgment. - A clear, written trigger list — agreed with your urologist — that says what change would move you from surveillance to treatment.

Because you named sexual function and urinary control as priorities: ask your team, in specific numbers, what their own patients experience 6 and 12 months after surgery and after radiation at their center. National averages exist, but individual surgeons and radiation programs vary. Ask what rehabilitation support they offer (pelvic floor therapy, PDE5 inhibitors, vacuum devices, penile rehabilitation programs).

• Do you agree Grade Group 1 makes me a candidate for active surveillance?
• What monitoring schedule do you recommend, in writing, for the next 24 months?
• What specific PSA change, MRI change, or biopsy change would trigger a move to treatment?
• If I chose surgery or radiation now, what are your center's actual continence and erectile-function outcomes at 6 and 12 months?
• Is there any reason — family history, MRI finding, genetic result — that would push you away from surveillance in my case?

You can search for open prostate cancer clinical trials, including studies of active surveillance, at prostatecancertrials.org. Bring anything that looks relevant to your urologist or oncologist to review together.

We do not have your MRI report, your full biopsy pathology (number of cores positive, percent involvement), family history of prostate or BRCA-related cancers, or any genomic test results (e.g., Decipher, Prolaris, Oncotype DX Prostate). Any of these can change how strongly active surveillance is recommended.

You are welcome to create another report when you have more information to include, such as MRI results, full biopsy pathology, family history, or genomic testing. You can include that new information along with any additional questions you have, and we will produce an updated report.