Prostate cancer treatment: watchful waiting

Watchful waiting can be a good option for men who are older, have other health concerns or whose prostate cancer is unlikely to shorten their lifespan.

How is prostate cancer
monitored on watchful waiting?

The aim of watchful waiting is to keep an eye on cancer growth and any symptoms that arise, through occasional testing.

Depending on your care team's guidance, here are tests to expect:

  • PSA tests: your doctor will usually want to monitor your prostate specific antigen (PSA) levels every 6 to 12 months.

  • Digital rectal exam (DRE): your health team may recommend this exam as part of your care.

  • Other blood and urine tests as necessary.

You likely won't need to have prostate biopsies, but your doctor or care team will speak with you about your plan.

Being a good candidate
for watchful waiting

When considering which treatment is right for you, doctors aim to do the least amount of harm. If having a more active or aggressive treatment looks like it may do more harm to you than good, you could be a candidate for watchful waiting.

Your doctor will review a number of factors to determine if watchful waiting is suitable, including:

  • Age: older men may be offered watchful waiting, to help avoid stressful treatment on the body.

  • Cancer type: watchful waiting can be suitable for men with localised, locally advanced and advanced prostate cancer.

  • PSA levels

  • Current health and fitness level: if your current health and fitness aren't in the best shape to undergo active treatment, watchful waiting may be offered.

  • Any history of other conditions or diseases: if you have other health concerns, watchful waiting can help avoid complicating other treatments you may be receiving.

After carefully reviewing all health factors, your doctor or care team will advise if watchful waiting is suitable. If you're a good candidate, the aim will be to keep an eye on cancer growth and any symptoms that arise, without aggressive treatment. This approach helps you avoid treatment you might not need, and could put too much stress on your body.

Are there
side effects?

Watchful waiting does not cause physical side effects. However, alert your care team if you begin to experience these issues:

These issues could be signs that the cancer is growing and may need further treatment. Your team will work with you to monitor health problems, along with your PSA, to determine if watchful waiting is still the best option.

Is watchful waiting different
from active surveillance?

You may have heard that they're the same, but watchful waiting differs from active surveillance in at least 3 ways:

  • Watchful waiting involves less intense PSA monitoring and tests, meaning you won’t have to check-in with your doctor as much.

  • If, at some point, you decide to move from watchful waiting to active treatment, the goal will be to slow the cancer growth and manage symptoms — but not to cure cancer.

  • Watchful waiting can be suitable for men with localised, locally advanced and advanced prostate cancer. Active surveillance is typically only suitable for men with localised prostate cancer.

What's next?

Now that you've read up on Prostate cancer treatment: watchful waiting, here are some related articles to explore as you continue to build your knowledge and understanding of this topic.
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