The first 60 days: Localised prostate cancer, very low and low risk
Low-risk prostate cancer is Grade Group 1 disease confined to the gland with a PSA under 10. It grows so slowly that watching it closely is the recommended first choice, and most men who choose surveillance never need treatment. Below, week by week, is what OnCo's record of Localised prostate cancer, very low and low risk says about the first two months: the order is typical, the timing is yours to ask about. Sections appear only where the record has something to say. Orientation, not medical advice.
What happens now
Staging tests establish exactly what and where the cancer is. Everything else follows from the answers.
MRI before biopsy and targeted plus systematic cores; genomic classifiers or AI pathology to refine surveillance decisions.
Ask which of these were tested and what the results were; see the report reader for what each value means.
These specialties appear in the standard of care for this cancer. In most centres they meet weekly as a tumour board to agree each plan; you can ask when yours was discussed and what was decided.
- PathologistNamed in the standard of care for: Very low and low risk, preferred, Diagnosis.
- RadiologistNamed in the standard of care for: Very low and low risk, preferred, Diagnosis.
- SurgeonNamed in the standard of care for: Very low and low risk, preferred, Low risk, men who prefer treatment, Diagnosis.
- Medical oncologistNamed in the standard of care for: Low risk, men who prefer treatment, Diagnosis.
- Clinical oncologist (radiotherapy)Named in the standard of care for: Low risk, men who prefer treatment.
A second opinion from a centre that treats many similar cases is normal, not rude; the standard of care tells you what to compare it against.
Each row is a setting from the standard of care, in the order it usually arises. Not all will apply to you; your stage and biomarkers decide which do. The guideline grade, where recorded, says how strong the evidence is.
Active surveillance with PSA every six months, MRI and repeat biopsy; treatment only on progression to Grade Group 2 or more.
Radical prostatectomy, moderately hypofractionated external beam radiotherapy, five-fraction stereotactic radiotherapy or brachytherapy, without hormone therapy.
Generated from this cancer's standard of care, biomarkers and open problems. Take the group that matches where you are. To tick, add your own and print, open the one-page appointment sheet.
Newly diagnosed
- What is my exact diagnosis, stage, and grade, and which tests established them?Everything else follows from an accurate stage and subtype.
- Which biomarkers have been tested on my tumour (for example PSA and PSA density, Gleason Grade Group 1 on biopsy, MRI PI-RADS score, Genomic classifier, Germline BRCA2 testing when family history warrants), and what were the results?These results decide eligibility for targeted therapy, immunotherapy, and trials.
- Which subtype is my cancer, and does that change the recommended treatment?Recognised subtypes for this cancer include Very low risk, Low risk, Localised acinar adenocarcinoma, Grade Group 1.
- Is germline (inherited) genetic testing recommended for me or my family?Inherited variants can change treatment and matter for relatives.
Very low and low risk, preferred
- For my situation (very low and low risk, preferred), which of the standard options do you recommend and why?Guideline options include: Active surveillance with PSA every six months, MRI and repeat biopsy; treatment only on progression to Grade Group 2 or more.
- How do the results of ProtecT apply to someone like me?Trial populations differ from individual patients; ask how closely you match.
Low risk, men who prefer treatment
- For my situation (low risk, men who prefer treatment), which of the standard options do you recommend and why?Guideline options include: Radical prostatectomy, moderately hypofractionated external beam radiotherapy, five-fraction stereotactic radiotherapy or brachytherapy, without hormone therapy.
- How do the results of CHHiP and PACE-B apply to someone like me?Trial populations differ from individual patients; ask how closely you match.
Diagnosis
- For my situation (diagnosis), which of the standard options do you recommend and why?Guideline options include: MRI before biopsy and targeted plus systematic cores; genomic classifiers or AI pathology to refine surveillance decisions.
- Am I a candidate for Decipher Prostate, ArteraAI Prostate, and what side effects should I expect?Knowing the expected toxicities helps you plan work, family, and supportive care.
- How do the results of PRECISION apply to someone like me?Trial populations differ from individual patients; ask how closely you match.
Any stage
- Are there clinical trials I could join, for example of ArteraAI Prostate, Decipher Prostate, Multiparametric prostate MRI (PI-RADS)?Trials are how the next standard of care is set; asking early keeps options open.
- Would a second opinion at a high-volume centre change anything, and can you help arrange it?Rare or high-stakes decisions benefit from a centre that treats many similar patients.
- What supportive care (symptom control, nutrition, exercise, mental health, financial help) is available from the start?Supportive care improves quality of life and helps patients complete treatment.
- I read that “Which Grade Group 1 cancers will upgrade, and whether Grade Group 1 should be called cancer at all”. How does that affect my plan?Open problems are where trials and second opinions matter most.
- I read that “How often to repeat biopsy on surveillance and whether MRI alone can replace it”. How does that affect my plan?Open problems are where trials and second opinions matter most.
Much of what helps in the first weeks is free if you know to ask: testing, helplines, rides and lodging, second opinions, trial travel.
- Localised prostate cancer, very low and low risk: the full pageLow-risk prostate cancer is Grade Group 1 disease confined to the gland with a PSA under 10. It grows so slowly that watching it closely is the recommended first choice, and most men who choose surveillance never need treatment.
- One-page appointment sheetYour questions, the words you may hear, what to bring, and space for the answers. Print it.
- Treatment sequencingWhich treatment tends to follow which, line by line.
- NavigatorStandard of care for your stage, what you have tried, and trials near you.
- Gleason score / Grade Group: The pathologist's 1-to-5 grade of how abnormal prostate cancer looks, which drives most treatment decisions.
- PSA (prostate-specific antigen): A blood protein made by the prostate; raised levels prompt further tests, and falling levels show treatment is working.
Every term links to the glossary.