Management options involve keeping check of the cancer. If there are any changes, your doctor can talk with you about starting active treatment. There are generally two management options for localised prostate cancer.
No treatment (watchful waiting)
Some men, for example people with other health issues who are not expected to live more than 10 years, will be regularly monitored and symptoms will be treated if they arise. If the cancer progresses they are treated with hormone therapy rather than a treatment with a curative intent such as surgery or radiotherapy.
Some men with low-risk prostate cancer can be regularly monitored with the Prostate Specific Antigen (PSA) test, digital rectal examination (DRE) and biopsy. If their disease appears more aggressive, they are offered treatment with a curative intent, usually by surgery, external beam radiation therapy (EBRT) or brachytherapy (a type of internal radiotherapy used in prostate cancer – see below).
- Fewer side effects than active treatments
- You can still monitor your cancer closely
- You may never need further treatment – if the monitoring suggests stability.
- You may need regular digital rectal exams and biopsies
- You might worry you’re not doing anything.
N.B. Sometimes the term ‘watchful waiting’ is interchangeably used instead of ‘active surveillance’, so it is important for you to be clear with the doctor as to what he or she means when active surveillance is suggested.