Because prostate cancer often grows very slowly, some men (especially those who are older or have other serious health problems) might never need treatment for their prostate cancer. Instead, their doctors may recommend approaches known as watchful waiting or active surveillance.
Active surveillance is often used to mean monitoring the cancer closely. Usually this approach includes a doctor visit with a prostate-specific antigen (PSA) blood test and digital rectal exam (DRE) about every 6 months. If your test results change, your doctor would then talk to you about treatment options.
Watchful waiting (observation) is sometimes used to describe a less intensive type of follow-up that may mean fewer tests and relying more on changes in a man’s symptoms to decide if treatment is needed.
When might these approaches be an option?
One of these approaches might be recommended if your cancer:
Isn’t causing any symptoms
Is expected to grow slowly (based on Gleason score)
Is just in the prostate
These approaches are not likely to be a good option if you have a fast-growing cancer (for example, a high Gleason score) or if the cancer is likely to have spread outside the prostate (based on PSA levels). Men who are young and healthy are less likely to be offered active surveillance, out of concern that the cancer might become a problem over the next 20 or 30 years.