Monitoring prostate cancer

What is watchful waiting?

Some locally advanced prostate cancers grow very slowly and may never cause any symptoms. For this reason, some men decide with their specialists 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. If treatment is given it is to control rather than cure the cancer.

You’ll be monitored, usually by your GP, to see if you have any new symptoms, such as difficulty passing urine or bone pain. You’ll also have regular blood tests to monitor your PSA levels and you may have digital rectal examinations.

If you develop symptoms, your GP will usually refer you back to your specialist at the hospital. You may be referred back if your PSA level rises. Your specialist will usually recommend hormonal therapy or possibly radiotherapy to control the cancer and improve its symptoms. If there’s no sign that the cancer is progressing or if it is only progressing slowly, it’s safe to continue with watchful waiting.

Advantages of watchful waiting

  • It avoids the complications and side effects of surgery or radiotherapy.

Disadvantages of watchful waiting

  • You may find it difficult to accept that your cancer is not being treated.
  • Some men will need treatment anyway if their cancer progresses.