Watchful Waiting A man who has selected watchful waiting is a man who has chosen not to have immediate prostate cancer treatment. During the watchful waiting period, the physician keeps the cancer under close watch and this is why it sometimes is referred to as active surveillance. The logic for watchful waiting is simple: prostate cancer often develops very slowly. With watchful waiting, the patient takes the time to consider possible treatment options. In some cases-particularly with older men-the prostate cancer patient will die of other causes rather than from prostate cancer. Other factors that motivate men to choose watchful waiting are the intrusiveness of many available treatments, the potential side effects, and in some cases limited long-term data. Today, with the availability of minimally invasive options, corresponding long-term data demonstrating efficacy and fewer side effects, more men are choosing treatment rather than life with cancer.

Watchful waiting entails regular prostate-specific antigen (PSA) tests, digital rectal exams (DRE) and/or other tests. "Waiting" means being alert for any indication that the cancer has developed to the point that it may require surgery or other treatment.

Choosing “watchful waiting”
Generally, watchful waiting is appropriate for men who meet one or more of these criteria:

• Short life expectancy
• Have significant other illnesses
• Have small tumors, a low Gleason score, and a low PSA level
• Any man fearful of treatment, regardless of age or health, also may choose watchful waiting.

Effectiveness of watchful waiting If you meet the criteria for watchful waiting, you may avoid the discomfort and possible side effects of treatment by choosing this option. If you have limited remaining life span or other serious disease, watchful waiting may enable you to maximize your quality of life and avoid prolonged recovery and other complications.

If you do not fit the criteria for watchful waiting, you may or may not benefit from this approach. If you are among those for whom untreated prostate cancer does not begin to rapidly spread, watchful waiting may be a viable option. However, if the cancer later begins to spread, you may have lost any benefits associated with early treatment.

Risks of watchful waiting The major risk of watchful waiting is that without treatment, prostate cancer can grow and spread outside the prostate capsule before your next doctor's visit. Even small, slow-growing tumors may become rapidly growing tumors if left untreated. And sometimes prostate cancer that appears to be small and slow growing may be larger and more aggressive than originally thought.

Help for finding the best treatment
Deciding the best treatment for prostate cancer is a challenge. No single treatment or combination of treatments is right for everyone.

If you have prostate cancer, or symptoms of prostate cancer, act now. Contact a physician who specializes in treating prostate cancer. Click here to find a nearby prostate cancer doctor with experience in the latest medical advances.

Click here for more information about other prostate cancer treatments, including minimally invasive procedures such as brachytherapy and cryotherapy.