Treating Prostate Cancer with Watchful Waiting

Defining Watchful Waiting

Because prostate cancer often grows very slowly, some men (especially those who are older or have other serious health problems) may never need treatment for their prostate cancer. Instead, their doctors may recommend an approach known as watchful waiting, also known as expectant management, observation or surveillance. Watchful waiting is closely monitoring a patient’s condition without giving any treatment until symptoms appear or change.1

Advantages & Disadvantages

Watchful waiting has the obvious advantage of sparing a man with clinically localized cancer, who typically has no symptoms, the pain and possible side effects of surgery or radiation. On the minus side, watchful waiting risks decreasing the chance to control disease before it spreads, or postponing treatment to an age when it may be more difficult to tolerate. Of course, treatments may also improve over time if watchful waiting is chosen. Another potential disadvantage is anxiety; some men don't want the worry of living with an untreated cancer.2

Candidates for Watchful Waiting

The most obvious candidates for watchful waiting are older men whose tumors are small and slow-growing, as judged by low grade Gleason score and low stage. Many men who choose watchful waiting live for years with no signs of disease. A number of studies have found that, for at least 10 or even 15 years, the life expectancy of men treated with watchful waiting (primarily older men with less lethal forms of prostate cancer) is not substantially different from the life expectancy of men treated with surgery or radiation or, for that matter, of the population at large.3

Medical Care During Watchful Waiting

Watchful waiting does not mean that you will not receive medical care or follow-up. Rather, your cancer will be carefully watched and monitored. Usually this approach includes a PSA blood test and digital rectal examination (DRE) every 6 months, possibly with yearly transrectal ultrasound-guided biopsy of the prostate. If you develop bothersome symptoms or your cancer begins to grow more quickly, you can consider active treatment.4

  1. "Detailed Guide: Prostate Cancer - Expectant Management (Watchful Waiting)," American Cancer Society, www.cancer.org. URL: http://www.cancer.org/docroot/CRI/content/CRI_2_4_4X_Expectant_Therapy_Watching_and_Waiting_36.asp
  2. "Treatment Choices for Men with Early-Stage Prostate Cancer," National Cancer Institute, www.cancer.gov. URL: http://www.cancer.gov/cancertopics/prostate-cancer-treatment-choices/page3
  3. "Prostate Surgery or Watchful Waiting: Which is Better?," American Cancer Society, www.cancer.org. URL: http://www.cancer.org/docroot/NWS/content/NWS_1_1x_Prostate_Surgery_or_Watchful_Waiting_Which_Is_Better.asp
  4. "Detailed Guide: Prostate Cancer - Expectant Management (Watchful Waiting)," American Cancer Society, www.cancer.org. URL: http://www.cancer.org/docroot/CRI/content/CRI_2_4_4X_Expectant_Therapy_Watching_and_Waiting_36.asp

While clinical studies support the effectiveness of the da Vinci® System when used in minimally invasive surgery, individual results may vary. Surgery with the da Vinci Surgical System may not be appropriate for every individual. Always ask your doctor about all treatment options, as well as their risks and benefits.