Watchful Waiting

Watchful Waiting is usually offered either to older men, where the disease may grow so slowly that it may not affect the person’s quality of life, or to those whose health may not allow them to undergo a treatment such as radiotherapy or surgery. Unlike Active Surveillance, the aim of any treatment will be to delay progression of the disease or to be palliative, i.e. not intended to cure the disease.

Watchful Waiting will involve attending an out-patients’ clinic once or twice a year for regular PSA tests and possibly a digital rectal examination (DRE), where the doctor inserts a gloved finger into the back passage to feel the prostate. Should the cancer progress, the most likely treatment option would be hormone therapy (see Hormone Therapies), depending on any rise in PSA levels.

Watchful Waiting, however, does not necessarily mean doing nothing. You may like to consider:

  • changing your diet
  • nutritional supplements
  • an exercise programme.

These may help in slowing the growth of the cancer cells. Your NHS Macmillan dietitian can advise you on diet and nutrition. You should, of course, consult your doctor before starting any new exercise regime.

Monitoring your PSA

PSA velocity (the rate at which the PSA increases) and doubling time, together with other factors, play an important part in Watchful Waiting. It is therefore important that you keep a careful record of your PSA results.