Prostate cancer > Treatment options for prostate cancer that has not spread beyond the gland
The most appropriate treatment will depend on several factors:
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| For example, for older men with small tumours and those with other severe illnesses, often the best option is what is known as active surveillance or 'watchful waiting'. |
Active surveillance
When you first hear of active surveillance (watchful waiting), you may think ‘What a cop–out’, and media reports of older patients receiving second-rate healthcare may spring to mind. But active surveillance is not a second-rate option at all – it is often a way of allowing you to retain maximum quality of life.
The chance that a small, slow-growing tumour will cause problems to an older man before the end of his natural life is often relatively slight. On balance, the side effects of the other treatment options would probably cause far greater distress. As the name suggests, although you will not receive treatment, you will have regular check-ups and your urologist will monitor your condition closely with PSA measurements, scans and sometimes repeat prostate scans and biopsies.
If you choose the active surveillance option you must, for your own peace of mind, be convinced that it is right for you. Despite all the progress made in early diagnosis and treatments, a diagnosis of cancer of any kind is still distressing for the patient, and for his family and friends. It would be a rare person who, having been told that he has cancer, then manages to put the diagnosis out of his mind. It is all too easy to understand everything and feel confident that you are doing the right thing while you are in the urologist's consulting room, and then a few weeks later start to feel panicked and uneasy that nothing is being done about your condition. Remember that the whole point of active surveillance is that your quality of life remains good - if you start to worry needlessly, perhaps losing sleep, then your quality of life is suffering. If this happens, pick up the phone or write to your GP or urologist and tell him how you feel. You might also find that becoming involved with a support group helps to keep you informed.