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Prostate Cancer Treatment Options - Watchful Waiting

By Edited Nov 13, 2013 0 0

In some cases it might be better not to treat the cancer immediately but rather wait to see how it progresses. This option is sometimes appropriate because prostate cancer is usually slow to develop and the patient my not want to risk having the side effects inherent in treating the cancer. In some cases where the life expectancy of the patient is low, due to his age or the presence of another life threatening disease, watchful waiting may also be considered.

In a Swedish study of 695 men diagnosed with prostate cancer between 1989 and 1999, half of the men were place on a watchful waiting list and the others had prostate surgery. After follow-ups had been done (on average 6.1 years), the men who were on the watchful waiting list had the following results:

  • In 31 percent of the cases, the cancer had spread outside the prostate
  • In 16 percent of the cases, the cancer had spread to other organs
  • In 9 percent of the cases, the cancer had killed the man


The men who had had surgery faired as follows:

  • In 12 percent of the cases, the cancer had spread outside the prostate
  • In 10 percent of the cases, the cancer had spread to other organs
  • In 5 percent of the cases, the cancer had killed the man


Another study of 767 Americans aged 55 to 74, who all elected watchful waiting, found that 96percent had died after 20 years. The study also showed the percentage chance of a man dying from prostate cancer within 20 years based on his Gleason score. The scores and percentages are as follow:

  • Gleason score of 5 = 10 percent of chance of dying
  • Gleason score of 6 = 27 percent of chance of dying
  • Gleason score of 7 = 51 percent of chance of dying
  • Gleason score of 8 to 10 = 66 percent of chance of dying


While prostate cancer usually progresses slowly, the cancer growth can be larger or more aggressive than previously thought so the advantage, of treating the cancer early, may be lost if the watchful waiting option is used. Men often choose watchful waiting because of the embarrassing side effects that treating the cancer can have. Others may choose the wait and see approach because of the presence of another more serious life threatening disease that could kill them before the prostate cancer. However, watchful waiting is generally considered appropriate in these cases:

  • Where there is a short life expectancy
  • The patient has another life threatening illness
  • The patient has small tumors, a low Gleason score, and a low PSA level


Other prostate cancer treatment options include:
Brachytherapy Radiation
Cryotherapy (cryosurgery)
Hormone Therapy or Androgen Deprivation therapy
Radical Prostatectomy
Herbal Alternatives

Source: E. Fuller Torrey, and Carlton Stoiber. Surviving Prostate Cancer: What You Need to Know to Make Informed Decisions. Yale University Press, 2008


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