Prostate Cancer: Understanding Your Options

Although quick actions may save lives in the emergency room, rapid decisions aren’t always right for other patients—including men with prostate cancer.

Prostate cancer occurs mostly in men older than 65, although younger men can be diagnosed with it. It affects the gland located below the bladder and in front of the rectum.

Symptoms of prostate cancer can include a frequent need to urinate and a weak stream of urine. Screening tests, such as a rectal exam or blood test, can check for prostate cancer before it causes symptoms. A man should discuss the advantages and limitations of screening with his doctor. The U.S. Preventive Services Task Force recommends these conversations take place between the ages of 55 and 69, while the American Cancer Society (ACS) recommends they begin at age 50. African-American men or men with a family history of prostate cancer should begin speaking with their doctors at age 45, according to the ACS.

Many treatment options are available for men with prostate cancer, including surgery and radiation. Another choice is “watchful waiting,” sometimes called observation or surveillance. Men who choose this option delay their treatment until symptoms appear or change.

Here’s why waiting can be an option: Unlike some other cancers, prostate cancer usually advances slowly. It can take 10 to 30 years for a tumor to grow. So, some men with early-stage prostate cancer choose to “wait and see” before starting treatment. By doing so, they avoid treatment complications—such as impotence and incontinence—that could affect their quality of life.

Watchful waiting isn’t for everyone. Some men opt for surgery to remove the prostate, which remains a common way to cure prostate cancer.

Some questions to consider when reviewing the options:

Would I feel stressed knowing that I had cancer in my body and that I was putting off treatment?

How do I feel about the possible risks and benefits of treatment?

If I choose watchful waiting, can I stick to a schedule of frequent testing?

Remember, there’s usually no need to rush into a decision. Depending on what your doctor says, you may have several months to research your options. In the meantime, try talking with other men who have faced prostate cancer.