Say a man is in otherwise good health, and he can reasonably expect to live at least ten more years. His cancer is localized to the prostate, and therefore it’s curable now. If he does nothing about it, he may miss his golden opportunity for cure. There’s no way of predicting if or when cancer will make that fatal leap beyond the prostate. Even in its earliest stages, prostate cancer doesn’t always spread considerately, in logical, creeping, easy-to-predict steps. And unfortunately, men with the earliest stages of prostate cancer can have metastases before they ever even develop a palpable tumor that can be felt by a doctor’s gloved finger during a rectal exam.
But say a man is in his eighties. Even if his cancer is organ-confined and curable, it’s not likely that he will live long enough for
So who should opt for watchful waiting? At the top of this list should he men who are too old or too ill either to undergo the rigors of treatment or to live another ten years (long enough for such treatment to be worthwhile). Also in this group should be men with cancers that are considered too advanced to cure — men with stages T3 T4 N+, C and D. And finally, for men with cancers that are truly incidental (some men with, stage T1a and lie disease), watchful waiting is probably a reasonable gamble.
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