No treatment offered

[Den 22]

I have been diagnosed with slow growing prostate cancer and as such have been offered no treatment at all – just monitoring. I was very surprised and this has worried me. I don’t have any symptoms as such as the cancer was discovered during a routine medical MOT.

Is there anything I can do/should do?

[Dr Jon Rees]

Hi

I can understand your concern if you feel that nothing is being done for you. However, be reassured, no treatment (Urologists call it 'active surveillance') is a really good option for many men with prostate cancer.

If the cancer is very small and is not aggressively growing (you may have been told a Gleason grade - I would expect yours to be Gleason 6) then provided you are closely monitored treatment can often be avoided, if not forever then at least for a significant time. This protects you from the harm of 'over treatment' as surgery or radiotherapy carries the risk of making you incontinent or causing erectile dysfunction.

Take a look on the internet at sites describing active surveillance for prostate cancer and you will see it can be a really good option, protecting you from possible harm caused by the treatment, whilst ensuring you are watched carefully enough to avoid harm from the cancer. It is done with your best interests at heart, not to save money etc!

If you are still concerned it is worth discussing with your GP, or with your Prostate Cancer specialist nurse in the department looking after you...

[Mr Christopher Eden]

The contrary view is that tumours can and do grow during active surveillance and that the tools used to identify disease progression (PSA and prostate re-biopsy) are inaccurate. You need to understand (and agree to) the downside to active surveillance, as well as the upside. The former is not always given as much emphasis as the latter.

[Mr Benjamin Challacombe]

Den
It is certainly worth the team looking after you have done everything to make sure you truly do have low risk disease. This now involves an MRI scan and some sort of extended biopsy of the prostate to ensure there is nothing more significant going on. This should be done within the first year after diagnosis depending on your age, PSA etc.
Symptoms are pretty rare in early prostate cancer so that all makes sense.
Ben