Age is an important factor. However, the patient's individual preference is also important. If the serum PSA is tremendously elevated, then this might not be a good option, as other forms of treatment like hormonal treatment exist. People are interested in watchful waiting because of the obvious concerns for side effects for prostate cancer. These include sexual potency, urinary incontinence, and a decreased libido that can specifically happen with hormone deprivation therapy.
Some men are interested more in the quality of life than the quantity of life.
If a younger man in his 50's with a high grade cancer, a relatively high PSA, elects to undergo watchful waiting, I feel uneasy about this decision because of the expanded life expectancy of this patient and the fact that appropriate curative treatments exist, which in modern treatment methods of both surgery and radiation therapy techniques have gone a long way in preserving not only the quantity, but also the quality of life. Well, I'm afraid that our time with Dr. Ghaviamian has just about come to an end. Men should be cognizant about the inherent risk of prostate cancer, that since we have perhaps the most useful tumor marker known to mankind, that is, serum PSA, one should use this tumor marker and correct medical judgment in detecting prostate cancer at its early stages, where cure could be imminent. The outlook of a man with prostate cancer detected in its early stages is not grim. If detected early, prostate cancer is a curative cancer.