A look at Watchful Waiting for prostate cancer
As prostate cancer is very slow growing, and is often diagnosed in older men, it is often the case that the cancer will likely not result in death, but the person may die of other factors beforehand. If the size of the cancer tumour volume is low and it is not causing any problematic symptoms, then it may be recommended that you carry out watchful waiting for prostate cancer instead of receiving treatments such as brachytherapy and hormone therapy.
What is involved in prostate cancer watchful waiting?
If it is decided that the likelihood of the cancer spreading quickly is low, and that therapy is unnecessary, then you may receive prostate cancer watchful waiting. This will involve keeping a close eye for any changes in your condition. Usually you will be asked to come back for a DRE and PSA level checks every six months; every year it may be recommended that you have a prostate biopsy to physically check for changes in your condition.
When is the Watchful waiting approach recommended
As mentioned above if you are very old, and the cancer is slow growing and only found in the prostate, then watchful waiting may be an ideal approach as it removes the need for surgery and other prostate treatments. For younger people, a lot depends upon health, if you have been diagnosed with other more severe problems, then the doctor may decide that these are much more important to worry about than a slow growing prostate cancer.
Analysing the watchful waiting results
Depending upon the individual person (especially with relation to age) a doctor will decide what is an acceptable rate of growth of prostate cancer. Usually if the size of the tumour does not double in size during a one year period, and the cancer does not spread beyond the prostate, then the doctor will continue with the watchful waiting program.
What if the cancer advances during the watchful waiting period
If it is found that the prostate tumour advances in size more than desired during watchful waiting then the doctor may recommend that you receive a form of advanced prostate cancer treatment such as surgery, brachytherapy or prostate hormone therapy.
What are the pros and cons of watchful waiting
Having prostate cancer treatment often has side effects such as impotence and short term discomfort when urinating, by carrying out watchful waiting, a person can prolong the time to treatment and the risk of these side effects. A con of watchful waiting is that if advanced treatment becomes necessary the man will be having surgery at an older age; when he may find the procedure much more stressful.
Additionally the stress of knowing that you have cancer, but are doing nothing about it apart from watching it grow can have negative psychological effects. It is also possible that the condition is more advanced than thought, as not all areas of the prostate are analysed during a prostate biopsy.
Making the choice to carry out watchful waiting is very much dependent on a particular patients personal medical condition; for many especially older people or those with other severe medical problems then watchful waiting may be the right choice for you.
Although having advanced treatments lowers the risk of dying from prostate cancer, it has been observed that there is no difference in the expected life span of someone with a low risk cancer who caries out prostate watchful waiting, over those who decide to have radical prostatectomy; this is largely due to the person's lifespan being cut short by other conditions than the slow growing prostate cancer. As ever don't be afraid to ask the doctor for advice on what is the best choice for your own personal circumstances.