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Because prostate cancer often grows very slowly, some men (especially those who are older or who have other major health problems) might never need treatment for their cancer. Instead, their doctor may suggest approaches known as watchful waiting, expectant management, observation, or active surveillance.

Some doctors use these terms to mean the same thing. For other doctors the terms mean something slightly different:

  • Active surveillance is often used to mean watching the cancer closely with PSA blood tests, digital rectal exams (DREs), and ultrasounds at regular intervals to see if the cancer is growing. Prostate biopsies may be done as well to see if the cancer is starting to grow faster. If there is a change in your test results, your doctor would then talk to you about treatment options.
  • Watchful waiting (observation) is sometimes used to describe a less intense type of follow-up that may mean fewer tests and relying more on changes in a man’s symptoms to decide if treatment is needed.

Not all doctors use these terms exactly this way. No matter which term your doctor uses, it’s very important to understand exactly what they mean when they refer to it.

Either of these methods may be a good choice if the cancer is not causing any symptoms, is likely to grow slowly, and is small and contained in the prostate. It is less likely to be a good choice if you are young and healthy, or have a cancer that is likely to grow fast (based on the Gleason score).

Some men choose this approach because they feel that the side effects of treatments like surgery or radiation might outweigh the benefits for them. Others are willing to accept the possible side effects of these treatments to try to remove or destroy the cancer.

Last Medical Review: 01/09/2015
Last Revised: 02/09/2016