Wait and see approach to prostate cancer
Dr. Joseph Worischeck, MD, is a urologist at Banner Baywood Medical Center. For more information on this topic, talk with your doctor.
Question: I was recently diagnosed with prostate cancer, but my doctor is suggesting we take a “wait and see” approach instead of immediate treatment. Won’t my cancer progress quickly without treatment?
Answer: Taking into account a number of factors, including your age, health history and the size and stage of your cancer, your doctor is recommending an approach called active surveillance, or “watchful waiting.” Certain forms of prostate cancer, unlike many other cancers, progress very slowly and may not affect your quality of life or cause serious symptoms if left untreated.
For men with these low-risk forms of prostate cancer, active surveillance, which requires the patient to have regular checks but no immediate radiation therapy or surgery, may be the optimal way to manage the cancer. Particularly beneficial for older men, watchful waiting enables patients to avoid treatment-related side effects, like incontinence, impotence and the general risks of surgery and radiation, as well as the financial costs of treatment. In fact, active surveillance has been such a reasonable approach, nearly half of all men with newly diagnosed prostate cancer are candidates for it.
During active surveillance, patients will undergo regular PSA blood tests, rectal exams, and repeat biopsies of the prostate on a certain schedule to determine if the cancer has progressed. Based on test results, the doctor will recommend continuing surveillance if there is no change or will propose a treatment plan if the cancer has changed.
Even with active surveillance, a patient may still need treatment eventually, as about one-third of men who follow this recommendation do require some form of treatment in the future. But the majority will not see their cancer progress enough to justify more invasive options, and the goal is to balance quality of life with appropriate management.