Watchful waiting is a way of monitoring prostate cancer that isn't causing any symptoms or problems. The aim is to keep an eye on the cancer over the long term, and avoid treatment unless you get symptoms.
Prostate cancer is often slow growing and may not cause any problems or symptoms in your lifetime. And many treatments for prostate cancer can cause side effects. For some men these side effects may be long-term and may have a big impact on their daily lives.
If you decide to go on watchful waiting, you won’t have any treatment unless you get symptoms, so you’ll avoid these side effects. Many men on watchful waiting never need any treatment for their prostate cancer. But for some men, their cancer may grow more quickly than expected.
If your cancer does grow more quickly than expected and you get symptoms, you can start treatment to control the cancer and help manage symptoms.
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Watchful waiting may be suitable for you if your prostate cancer isn’t causing any symptoms or problems, and:
It’s also important that you’ve discussed other treatment options with your doctor and you’re happy to go on watchful waiting.
What may be an advantage for one person might not be for someone else. Speak to your doctor or nurse about your own situation and the things that are important to you.
If you’re on watchful waiting you will have tests to monitor your cancer. You won’t have any treatment unless you get symptoms.
You’ll normally have a prostate specific antigen (PSA) blood test at your GP surgery or hospital clinic every 3 to 12 months. This will help to check for any changes to your prostate cancer.
You might also have digital rectal examinations (DRE) and other blood and urine tests. You probably won’t need to have prostate biopsies. These involve taking pieces of prostate tissue to look at under a microscope to check for changes to your cancer.
If any changes are picked up by these tests or you have any new or different symptoms, then you may be given an appointment with the doctor or nurse at the hospital.
What symptoms should I look out for?
You should let your GP or doctor or nurse at the hospital know if you notice any symptoms or changes to your health. Things to look out for include:
Ask your doctor or nurse if there are any other symptoms or changes to your health that you should look out for, as well as who to contact about them.
What happens if I get symptoms?
If you start to notice any of these symptoms you might need more tests to see if your cancer has spread, and you may be offered treatment.
The most common treatment to control the cancer and help improve symptoms is hormone therapy. This shrinks the cancer cells, wherever they are in the body. However, hormone therapy can also cause side effects.
There are also treatments available to manage specific symptoms. For example, if your prostate cancer has spread to the bones it can cause bone pain. Treatments to manage bone pain include:
There will be treatment options available to you if you don’t want to go on watchful waiting. These will depend on whether your cancer has spread and how quickly it might be growing, as well as any other health problems you have.
You should have all the information you need before making a decision.
It’s up to you whether to go on watchful waiting or have treatment – but it can be a difficult decision to make. You can discuss all your treatment options with your doctor or nurse – they’ll be able to help you weigh up the pros and cons. Give yourself time to think about what is right for you. And make sure you’ve got all the information you need, and have the details of someone to contact if you have any questions.
You can ask for a second opinion about your treatment from a different doctor, if you want one. You don’t have a legal right to a second opinion, but most doctors will be happy for you to have one and will refer you to a different doctor.
What if I change my mind?
If you’re on watchful waiting but decide you want treatment, speak to your doctor or nurse. They can discuss any treatments that may be suitable for you.
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