Watchful waiting involves observation and is generally aimed at avoiding treatment. It is usually regarded as a suitable approach for elderly men with locally advanced prostate cancer and a limited life expectancy (through age or other co-morbidities). It involves check ups with regular digital rectal examinations and PSA testing (6-12 monthly).
This approach may be preferred by some men as it enables them to avoid the side effects of treatment. But locally advanced prostate cancer is associated with a high risk of disease progression. Secondary symptoms and urinary problems are likely to develop if the disease progresses. Surgery may also be required to relieve bladder obstruction.
There is also evidence that immediate hormonal treatment could improve the survival for some men.(12),(16) Patients need to be fully informed about the implications of watchful waiting and to consider all these aspects carefully before making their decision.