March 16, 2009 -- Question: What is watchful waiting, and what are the advantages/disadvantages of this approach?
Answer: Watchful waiting is a management for treating prostate cancer without proceeding with active therapy. It's sometimes referred to as active surveillance or observation and instead of thinking of it as watching it and not treating it and letting it run it's course, it's a close follow up of the cancer and it's aimed at watching men who have unfavorable cancer and perhaps they may have a number of medical problems and a shorter life expectancy, and it allows them to avoid the side effects that are commonly seen with radiation or surgery. The advantage is in avoiding active treatment, you avoid the side effects. The down side it's a calculated risk that we have a number of predictors to try to suggest someone's cancer is slow growing and might be benign, but there's no perfect guarantee of that, and it's a risk that in the course of surveillance, the cancer could get worse.