Understanding watchful waiting
Watchful waiting is a management strategy we use at Birmingham Urology Centre for prostate cancer that is not causing symptoms. This approach is suitable if your prostate cancer is slow-growing and you prefer to avoid the side effects of aggressive treatments.
This approach involves regular monitoring of your condition without active treatment, such as surgery or radiation therapy, The aim is to avoid unnecessary treatment and potential side effects, until symptoms develop or change.
Monitoring prostate cancer
There are 2 ways to monitor prostate cancer
- Watchful waiting
- Active surveillance
The aim of both is to avoid having unnecessary treatment but they are different. Other terms such as ‘active monitoring’ or ‘watch and wait’ may be used. It is important to check with your urologist which one you’re being offered as the reasons for having them are different.
When to consider watchful waiting:
Watchful waiting is typically recommended if:
- You have prostate cancer that is not causing any symptoms or problems.
- Your prostate cancer is not expected to cause problems in your lifetime or shorten your life, often because you are older or have other health conditions.
- Treatment of your prostate cancer may not help you to live longer
This approach involves fewer tests and is focused on maintaining your quality of life rather than curing the cancer.
Initial assessment
A thorough evaluation is required initially to confirm that your prostate cancer is suitable for watchful waiting. This might include reviewing your PSA levels, biopsies, and medical history.
What to expect on watchful waiting:
- Regular prostate specific antigen (PSA) blood tests: To monitor for changes in your prostate cancer.
- Regular clinic appointments: To monitor your health and any progression of cancer.
- Close contact with our urology team: To ensure that any changes in your condition are detected early and managed appropriately.
- Further assessment: Only if any changes are picked up with tests or symptoms develop
What symptoms should I look out for?
Please contact your urologist without delay if you experience any of the following ‘new’ symptoms, or if you experience worsening of existing symptoms.
- Frequent urination, especially at night
- Difficulty or straining when urinating
- Weak urine flow
- Feeling like your bladder isn’t empty after urinating
- Blood in your semen or urine
- Bone pain (usually in the pelvic area or lower back)
- Feeling tired or unwell.
- Unexplained weight loss.
Advantages of watchful waiting:
- Avoids the side effects and risks associated with treatment such as urinary incontinence or erectile dysfunction.
- Requires fewer medical appointments and interventions such as biopsies.
- Has less impact on daily life and quality of life without the burdens of treatment side effects.
- Treatment can be started if you develop symptoms, or your prostate cancer progresses.
Disadvantages of watchful waiting:
- The cancer may grow more quickly than expected or become symptomatic, requiring later treatment.
- The uncertainty about the progression of your cancer may cause anxiety.
- Family members may worry and find it hard to understand why you aren’t having treatment.
Will I need treatment in the future?
This is difficult to answer, but it is possible that you will need future treatment. This will depend on your general health and how your cancer behaves in the future.
What happens if your condition changes?
If you develop symptoms or if tests indicate that the cancer is progressing, we can promptly adjust your care plan. Treatment at this stage often focuses on symptom management rather than cure, including options like hormone therapy to control cancer growth and manage symptoms such as urinary problems or bone pain.
What treatment would I be offered if required?
This would involve androgen deprivation therapy so-called ADT (male hormone reduction therapy). This is usually achieved by 3 monthly injections of hormones, usually into the abdomen which decreases the testosterone (male hormone) and therefore shrinks and controls the growth of the prostate cancer. We may sometimes also offer radiotherapy.
Making an informed decision with Birmingham Urology Clinic
Our specialists provide personalised care and are here to discuss all available treatment strategies to ensure you receive the best possible care tailored to your needs.
Choosing watchful waiting involves careful consideration of your current health, cancer characteristics, and your personal preferences. It’s important to discuss thoroughly with your consultant to ensure it aligns with your lifestyle and long-term health goals. If you ever feel uncertain or if your circumstances change, our team at Birmingham Urology Centre is here to reassess your treatment options and support your health journey. We ensure you have all the necessary information to understand the potential risks and benefits, helping you make an informed choice about your prostate cancer treatment.
Contact us if you have been diagnosed with prostate cancer and are considering watchful waiting, or if you have any questions about your prostate cancer management options. Our dedicated team is here to support you with expert advice and comprehensive care tailored to your individual needs.
