Will my dad’s low-risk prostate cancer turn aggressive?

Question

Hello doctor,

I am asking about my 70-year-old dad. His urologist recommended watchful waiting for his low-risk prostate cancer, but I am concerned we might miss the right time to treat it.

How can we tell when it is time to start treatment? Can low-risk cancer become aggressive unexpectedly? I do not want to regret waiting too long.

Please help.

Thank you in advance.

Answer 1

Hello,

Welcome to icliniq.com.

I read your query and can understand your concern.

It is understandable to feel concerned about your father’s prostate cancer and the watchful waiting approach. Here is a clearer look at the situation:

Understanding low-risk prostate cancer:

Low-risk prostate cancer typically grows slowly, remains confined to the prostate, and is unlikely to spread. It is classified using PSA (prostate-specific antigen) levels, Gleason scores (a grading system used to evaluate the aggressiveness of prostate cancer), and tumor stage.

What is watchful waiting?

This involves regular monitoring without immediate treatment, focusing on the slow nature of the cancer. Treatment begins only if signs of progression arise, such as:

Rising PSA levels.
Symptoms like urinary issues or pelvic discomfort.
Imaging results suggest increased aggressiveness.

When to consider treatment:

Monitoring: Regular PSA tests and, if needed, repeat biopsies help detect changes.
Progression: A gradual rise in PSA, new symptoms, or concerning imaging results may signal the need for treatment.
Consultation: Open communication with the urologist about monitoring results, risks of progression, and treatment options is vital.
Second opinion: If unsure, consulting another specialist can provide clarity.

Balancing risks and quality of life:

It is natural to worry about missing the window for treatment. However, many low-risk cancers do not progress significantly, especially in older men. The key is balancing the risks of delayed treatment with the side effects of interventions like surgery or radiation.

A detailed discussion with his healthcare provider, considering his overall health and preferences, will help determine the best course of action.

I hope this helps.

Kindly revert so I can assist you further.

Thank you.