Prostate cancer tends to be a slow growing disease and treatments do have side effects. Therefore, in some cases, it may be reasonable and safe to wait and carefully monitor the cancer’s progress before deciding to start treatment. This process is called “watchful waiting”.
In general, only men with low-stage and low-grade tumours should consider watchful waiting. You doctor may suggest treatments like surgery or radiation if your tumour starts to grow and spread. If your prostate biopsy confirms a small volume tumour (Stage 1), which is low-grade (Gleason sum 5-6), watchful waiting may be right for you.
When men with other conditions such as, severe heart or lung disease, other types of cancer, or men in their 80s or 90s, are diagnosed with prostate cancer, although treatment is technically possible, many doctors will suggest putting it off because treatments can cause more problems than the disease itself.
Watchful waiting involves regular and careful monitoring of the tumour with:
This program of constant testing is not right for every man. The main advantage is delaying or avoiding invasive treatment and its side-effects. Canadian research suggests that watchful waiting is low risk; most men who choose to start treatment after a period of watchful waiting respond well to therapy.
To learn more about watchful waiting, watch Dr. Laurence Klotz MD, FRCSC, Professor of Surgery, University of Toronto, discuss prostate cancer, PSA levels and the benefits of watchful waiting for some patients.