Watchful Waiting

It is another way of monitoring your prostate cancer. It avoids the need for active treatment such as surgery or radiotherapy. This means you won’t get side effects that may affect your everyday life. It is different to active surveillance.

What is watchful waiting?

This is another way of monitoring your prostate cancer. It avoids the need for active treatment such as surgery or radiotherapy. This means you won’t get side effects that may affect your everyday life. It is different to active surveillance because:

  • You will have fewer check-ups
  • If your cancer changes, your doctor will talk to you about controlling your cancer and your symptoms rather than curing your cancer. 
Watchful Waiting

Important things to know

Who can have watchful waiting?

You can go on watchful waiting if:

  • Your prostate cancer is contained within your prostate (localised) or has spread just outside your prostate (locally advanced) and you: 
    • Have health problems and are not able to have other treatments 
    • Do not want to have treatment.
  • Your cancer has spread but you have no symptoms.
  • You have a slow growing cancer that is not likely to cause problems in your lifetime. 

 

What are the main benefits of watchful waiting?

  • You won’t have to have regular biopsies, which can be uncomfortable.
  • You will put off treatment that may cause side effects, until it is necessary. Or you may avoid treatment altogether.
  • If you do get symptoms, your doctor can help you to control and manage them. Many men never get any symptoms. For example, hormone therapy can help to improve symptoms. 
Maurice WW
“My health is fine, my fitness levels are fine, but every so often you have dark days but there is always sunshine and every day is a new day".
Maurice
Frequently asked questions (FAQs) about watchful waiting
PSA test

  

  • If you begin to develop other symptoms, such as bone pain, your doctor may send you for a CT or bone scan. This is to see if your cancer has spread. To learn more about CT and bone scans, visit our ‘testing and diagnosis’ page (this link will open in a new tab).
Hormone therapy (tablets)

Your doctor will talk to you about managing and controlling any symptoms. This may mean you have hormone therapy. Hormone therapy can help to shrink prostate cancer and slow down its growth. It may help to improve any symptoms you are having. Visit our page on hormone therapy  to find out more. This link will open in a new tab.

Radiotherapy

If your cancer has spread to your bones, you may be offered other treatments such as radiotherapy. The radiotherapy is given to the area of bone affected by the cancer. This is used to control the cancer and improve your symptoms. It will not cure your cancer. Visit our page on radiotherapy to find out more. This link will open in a new tab.

  • As you are not having any active treatments, you should not have any pain
  • If your cancer grows or spreads, you may start to get symptoms such as bone pain.
  • You will need to take time off work for your PSA blood tests
  • If your cancer grows or spreads, you may need to visit the hospital to see your doctor or nurse. 

Talk to your doctor or nurse if:

 

    You start having problems peeing

 

 

 

    You get pain in your bones

 

 

 

    You feel constantly tired and weak

 

 

weight loss

 

  You have lost weight and you don‘t know why.

  • If you start to get symptoms, your doctor will talk to you about treatments that will help to manage and control these symptoms. For example, hormone therapy or radiotherapy. 
  • Your cancer may change and spread and start to cause you symptoms. 
  • Being on watchful waiting can make some people feel anxious. They can worry about their cancer growing. You can always talk about any concerns you have with your doctor or nurse. 
  • People around you may find it hard to understand why you are not having treatment.  

About this information

  • This information was published in March 2023. Date of next review: November 2024.
  • References and bibliography available on request.
  • If you want to reproduce this content, please see our Reproducing Our Content page.

What is risk?

  • Risk is the chance something bad could happen when we do something. Even simple things such as walking down the stairs can have risks. But we take risks because we think it will be worth it. We need to think about both the benefits and risks of what might happen when we do something.
  • You should always ask your healthcare team about both the benefits and risks of any treatment.
  • Remember if they tell you about a risk, it doesn‘t mean it will happen to you. They may say one man in ten who has this treatment will have a side effect. But they can‘t tell you if you will be the ‘one’ man who gets this side effect.
showing a see saw with risk on one side and benefits on the other
  • Your cancer may change and grow between tests 
  • You may worry about your cancer growing and getting symptoms
  • People around you may find it hard to understand why you are not having treatment. 
Older White man talking to doctor

About this information

  • This information was published in March 2023. We will review it in September 2024.
  • References and bibliography available on request.
  • If you want to reproduce this content, please see our Reproducing Our Content page (this link will open in a new tab).

What is the impact?

  • We asked real visitors to the infopool to share their experience of this treatment. They told us how this treatment had impacted their everyday lives in a number of different areas.
  • The numbers and images below represent how many people said this treatment had impacted them ‘a lot’ in each of the different areas. As this site is new, this is currently based on a relatively small group of people who have responded about this treatment. Please take this into account when reviewing the information below.
  • For example, imagine it says ‘25 in 100’ underneath ‘physical and social wellbeing’. This means that 25 out of 100 people who shared their experience of this treatment told us it impacted their ‘physical and social wellbeing’ a lot. However it would also mean that 75 out of 100 people said it had not impacted them a lot.

Physical and social wellbeing

Enjoying activities such as walking or going out to the pub

43 out of 100

Effect on relationships

Ability to make good connections with others

30 out of 100

Sexual activity

Ability to reach sexual arousal, either physically or emotionally

26 out of 100

Sense of self

Knowing who you are and what motivates you

17 out of 100

Wellbeing and quality of life

Feeling good and functioning well in your personal and professional life

30 out of 100

Mental and emotional health

Ability to think clearly, make good decisions, and cope with your emotions

30 out of 100

Fatigue

Feeling of constant physical and/or mental tiredness or weakness

39 out of 100