Prostate Cancer: Is Treatment Necessary?

In some cases of early-stage diagnosis, monitoring prostate cancer is an effective alternative to treatment.

It seems counterintuitive to not treat cancer. Yet there are some men who can maintain their quality of life without having their prostate cancer treated – and live as long as those who have immediate surgery. For these men, watchful waiting or active surveillance might be recommended in lieu of surgery or radiation therapy.

“Certainly, screening can lead to earlier prostate cancer detection, and with earlier detection, you’re eligible for multiple different treatments or active surveillance,” said Sia Daneshmand, MD, associate professor of urology at Keck School of Medicine of USC and director of urologic oncology at the USC Institute of Urology at Keck Medicine of USC. “So we encourage patients who are candidates for screening to discuss it with their urologist and/or primary care physician so that we can determine what’s the best course of treatment for them.”


Observing your cancer, also known as “watchful waiting,” means monitoring your symptoms and using them a guide to decide whether treatment is needed. While you are still observing your cancer closely, you will have fewer tests and doctor visits after your diagnosis.

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Active surveillance

Active surveillance is actively monitoring cancer with doctor visits, prostate-specific antigen (PSA) blood tests and digital rectal exams (DRE) every six months. Your doctor might also recommend a biopsy to see if your cancer changes. If your cancer begins to grow, hormone therapy may be started.

Is this method right for your type of prostate cancer? Maybe so, if you fit any of the following criteria:

A young patient with slow-growing prostate cancer and no symptoms

Doctors do not know if treating cancer with surgery or radiation will help you live longer. These treatments aren’t without risk, and the side effects could outweigh the benefits. If you do not have any symptoms of cancer or if your cancer is slow growing, in stage 0 or 1, small, and limited to only your prostate, observation and active surveillance might be options for you.

An older man with other health conditions

Surgery and chemotherapy can complicate existing health conditions or create new ones. That’s why doctors will sometimes advocate that older men forego prostate treatment. One study found that for men age 75 and older who are diagnosed with prostate cancer, the risk of dying from cancer is lower than the risk of dying from another health condition.

Someone with serious health problems

Serious health problems like diabetes or heart disease can be exacerbated with prostate cancer surgery and other treatments.

Someone with concerns about incontinence, erectile dysfunction or infertility.

While radiation is an effective treatment for cancer, it can complicate sexual performance and fertility. You might opt to bank your sperm in case you proceed with treatment.

If you suspect you have prostate cancer, the USC Institute of Urology at Keck Medicine of USC provides a comprehensive environment for the diagnosis and treatment of prostate cancer. If you are in the Los Angeles area, make an appointment by calling (800) USC-CARE (800-872-2273) or visiting

By Heidi Tyline King