Watchful waiting and locally advanced prostate cancer

Prostate cancer can grow slowly and you may have little or no symptoms when you are diagnosed. Your doctor may decide to watch (monitor) you for a period of time before starting treatment.

During this time you will have regular PSA tests and check-ups to check that your cancer is not growing too quickly. The idea of watchful waiting is to delay starting treatment, because of the side-effects of treatment and because the treatment can work just as well if started at a later date.

You may be suitable for watchful waiting if your prostate cancer is not causing you any symptoms or problems at present. Also, you may not be fit enough for treatment, especially if you have other health conditions.

What does watchful waiting involve?

If you opt for watchful waiting, you will not begin treatment straight away. Usually you will be asked to have your PSA checked every 4-12 months, depending on your individual situation.

From time to time you will have digital (finger) rectal examinations as well as your blood tests. You will usually not need to have repeat prostate biopsies done while on watchful waiting. If the tests show changes in your PSA level or the size of your prostate gland, or if you develop other symptoms, your doctor will talk to you about whether you need to start hormone therapy.

You may start treatment once your PSA reaches a certain point or if you get symptoms such as problems passing urine or bone pain. Let your GP or doctor or nurse at the hospital know if you have any symptoms. You may need to have some further tests to see if your cancer has spread.  Hormone therapy can be given once your doctor and you decide to start treatment.

Advantages of watchful waiting

  • You will avoid the physical side-effects of treatment and should be able to enjoy your normal life and activities

  • You will not need to have invasive tests such as regular prostate biopsies

Disadvantages of watchful waiting

  • You might become anxious or worry about your cancer changing and the chance of developing symptoms

  • Your partner or family may worry about you and find it hard to understand why you are not having treatment

  • The cancer might change more quickly than expected. If this happens you can start treatment to help control the cancer

If you would like more advice about watchful waiting or if you would like to talk to a cancer nurse in confidence, call our Cancer Nurseline on 1800 200 700 or call into a Daffodil Centre. You can also download our booklet Understanding prostate cancer.

You can also keep a record of your PSA blood tests by recording them in the Prostate Passport. Call our Cancer Nurseline on 1800 200 700 if you would like a copy. 

Date Last Reviewed: 
Thursday, December 6, 2018