Watchful waiting for locally-advanced prostate cancer
Some locally-advanced prostate cancers grow very slowly and may never cause any symptoms. For this reason, some men and their specialists decide to wait and see whether the cancer is getting bigger (progressing) before starting any treatment.
This is called watchful waiting and is a way of avoiding treatment for as long as possible.
Your doctors (either your GP or hospital doctor) will monitor you to see if the cancer is growing significantly or causing any symptoms. At each visit your doctor will ask you about your symptoms. They may also examine you, which may include a digital rectal examination. If your symptoms change or your doctor suspects that the prostate is growing, further tests will be done. You are likely to have the PSA test repeated. X-rays, MRI scans and bone scans may also be needed.
If these tests show that the cancer is starting to grow, or if you develop more symptoms, your doctors will then consider treatment options that will aim to control the cancer and improve its symptoms. If the cancer is not growing or developing, it’s safe to continue with watchful waiting.
You can read more about the tests used during a period of watchful waiting in our section on tests for prostate cancer.
Advantages and disadvantages of watchful waiting
Many men who choose watchful waiting will avoid the side effects of treatments such as hormonal therapy or radiotherapy.
Some men find it difficult to wait and see if their cancer progresses before starting any treatment, especially since doctors can’t predict when this might happen or whether it will happen at all. Some men will need treatment with radiotherapy or hormonal therapy anyway if their cancer shows signs of developing.