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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.

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.

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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 maximise 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.

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.

 
   
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