Watchful waiting is an option whereby nothing is done to treat prostate cancer at the time of diagnosis. Our team of medical experts monitors the cancer to see if it progresses. Typically, the PSA value is assessed at regular intervals to see whether it is increasing and at what rate. This is called the PSA velocity. Until a certain threshold is reached with PSA value or the onset of bone pain occurs, any treatment is on hold. Watchful waiting is ideally suited for individuals with other life-threatening medical conditions and older patients whose bodies would not be able to handle the trauma of surgery or vigorous therapies. Obviously, if the PSA velocity increases rapidly, then a course of treatment needs to be put in place as soon as possible, regardless of age or health.
If you ask the radiation oncologist, "How am I doing? Is the cancer all gone? Am I cured?" he or she cannot answer these questions immediately, as is the case following surgery. After radiation therapy, the response may take months to become fully manifest. Dead cancer cells have to be gradually disposed of by the body. Some cancer cells, even if technically dead (., they cannot multiply), may continue to function for some time before they ultimately die. For successful radiation therapy, the PSA level drop is much slower than that of surgery. The PSA usually drops by half every three to four months after the radiation, and typically to the lowest level in about 12 to 18 months.
Deprivation gradient statistics were calculated using incidence data for three time periods: 1996-2000, 2001-2005 and 2006-2010 and for mortality for two time periods: 2002-2006 and 2007-2011. The 1997-2001 mortality data were only used for the all cancers combined group as this time period includes the change in coding from ICD-9 to ICD-10. The deprivation quintiles were calculated using the Income domain scores from the Index of Multiple Deprivation (IMD) from the following years: 2004, 2007 and 2010. Full details on the data and methodology can be found in the Cancer by Deprivation in England NCIN report.