Watchful waiting is a method of monitoring prostate cancer that doesn't cause any symptoms or signs of problems. The goal is to observe the cancer over the long term and avoid treatment unless symptoms develop. Prostate cancer often grows slowly and might never cause significant issues. Many prostate cancer treatments can lead to side effects, some of which can be long-term and significantly impact quality of life. Men can avoid these side effects by opting for watchful waiting until treatment becomes necessary.
Who Can Opt for Watchful Waiting?
Watchful waiting is suitable for men whose prostate cancer is not causing symptoms and may not benefit from immediate treatment. This approach is generally recommended for men who:
- Have other health conditions that make treatments like surgery or radiotherapy less beneficial.
- Have prostate cancer that is unlikely to cause problems during their lifetime or shorten their life expectancy.
What are the Advantages and Disadvantages of Watchful Waiting
Benefits:
- Avoids Side Effects: Men can avoid the side effects associated with prostate cancer treatments.
- Fewer Tests: making it less invasive and disruptive.
- Focus on Symptoms: If symptoms develop, treatments are available to manage them effectively.
Disadvantages:
- Potential Growth: There is a risk that the cancer may grow and spread, requiring more aggressive treatment later on.
- Worry and Anxiety: Some men and their families might worry about the cancer growing unchecked.
- Health Changes: General health could decline, potentially challenging future treatments.
How Does Watchful Waiting Work?
It is a programme offered to men with prostate cancer, where the prostate cancer is managed conservatively, and only the symptoms are addressed. The typical issues addressed are;
- Changes in urinary habits, such as needing to urinate more often, especially at night.
- Problems with urination, including weak or slow flow.
- New aches and pains in the back or bones.
- Fatigue or extreme tiredness.
- Unexplained weight loss.
- New swelling in the legs.
What If Symptoms Develop?
Further tests may be required to see if the cancer has spread if symptoms develop. The most common treatment for managing symptoms and controlling the cancer is hormone therapy, which works by shrinking cancer cells and slowing their growth. However, hormone therapy can also cause side effects.
Comparing Watchful Waiting to Active Surveillance
While both watchful waiting and active surveillance aim to avoid unnecessary treatment, their purposes and methods differ:
- Watchful Waiting: Suitable for men with other health issues. It aims to manage symptoms rather than cure cancer. It involves fewer tests and check-ups, usually done at a GP surgery.
- Active Surveillance: Suitable for men with localised prostate cancer who could benefit from treatments like surgery or radiotherapy if needed. It involves frequent hospital tests, including MRI scans and biopsies, to monitor the tumour closely.
What do urologists think about watchful waiting?
Choosing watchful waiting allows men to avoid the immediate side effects of prostate cancer treatments while keeping an eye on their health. Regular monitoring and timely treatment, if symptoms develop, can help manage cancer effectively. Discussing all available options with a doctor or specialist nurse ensures that men can make an informed decision best suited to their health needs.
