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Clinically localized disease

Watchful Waiting

Watchful waiting can be appropriate for patients whose cancer has been detected at a very early stage in whom the amount of cancer is very small (as measured by PSA test and amount of cancer on biopsy) and when the cancer is not highly aggressive (Gleason score 6 or less, and occasionally Gleason 7).

The main advantage of watchful waiting is that side effects of surgery, radiation, or hormonal treatment, such as impotence, are avoided. To determine whether or not a cancer is showing signs of having the potential to grow or spread, patients undergo rectal exam, PSA test, and biopsy at regular intervals if they are undergoing watchful waiting. If the cancer shows aggression during follow-up, such as by substantial rise in PSA or increase in amount of cancer on biopsy, then more aggressive treatment (surgery, radiation or hormonal) can be undertaken.

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