Prostate cancer unlike most other cancers is usually a slow growth cancer. Most men over the age of seventy with prostate cancer will probably die of something else. But because my PSA had doubled from 4.5 to 9.1 in a year, watchful waiting wasn’t an option.
I am a Vietnam Veteran and the Veterans Administration assumes I was exposed to Agent Orange. Agent Orange was used in Vietnam as a defoliant and exposure to it causes a wide range of nasty diseases, prostate cancer being one of them. I will discuss this more in another article.
Watchful waiting may also be called expectant management, observation, and/or active surveillance. What exactly does watchful waiting mean? Well what it doesn’t mean is to ignore the warning signs of a high PSA. What it does mean is working with your doctor to set up a protocol that includes regular monitoring of your PSA.
Some doctors may prefer closely monitor your prostate and some may describe a less intensive approach. Using a variety of methods such as PSA blood test, digital rectal exams, biopsies and ultrasounds it’s possible to carefully monitor your cancer and take action if there is a change in your test results.
I should point out here that like most men my prostate and the idea of being constantly examined didn’t appeal to me. After all we’re talking about a most intimate part of the male anatomy. This being the case it’s critical to find a doctor who you feel comfortable with and who is willing to answer your questions and discuss all the options.
With active surveillance or watchful waiting only men whose cancer is growing will be treated. For men with lower PSA this means avoiding the many side effects of aggressive procedures such as surgery. Of course if you go the route of watchful waiting there is the danger that the cancer will spread. If this happens then your treatment options maybe limited.
Older men especially those with other serious health problems watchful is a viable alternative. But for younger men who are in good health and who have many years ahead of them a more aggressive treatment plan is probably the best choice.
Whichever option you choose watchful waiting or more aggressive intervention remember these points. First of all unless your cancer when detected is in an advance stage, you have time to carefully consider your opinions. Secondly find a doctor you are comfortable with and that you trust. Thirdly weigh all the options and if watchful waiting is for you follow your doctor’s advice and make sure you monitor your PSA on a regular schedule.