Because prostate cancers can grow slowly and may not cause any problems for years, many men (especially elderly men and men who may have other significant health problems)may opt for a period of observation with no treatment unless symptomatic problems arise. It has been shown that For men who have less than a 10-year life expectancy, it has been shown that observation is just as effective as surgery and/or radiation treatment. However, if observation is chosen, it is important to realize that the cancer may continue to grow. Common symptoms that may develop include bone pain and difficulty urinating. If such symptoms develop, hormone therapy may be given to control the cancer growth, and radiation may relieve symptoms. The major difference between observation and surgery or radiation (as initial treatment) is that with observation there is no attempt to cure the patient of the cancer. All efforts are directed at treating problems only as they arise.

In general, since the advent of the PSA testing, which is often used to see how well you have responded to therapy, the treatment of early stage prostate cancers either with surgery and/or radiation with either external beam or implantation, has been found to be equivalent as it relates to PSA findings and survival. It is important to note that recently information has been presented that suggests the complication rates are much higher in patients who undergo surgical procedures than was previously appreciated.

Controversy exists as to whether PSA screening will increase the cure rate of prostate cancer. However, the combination of PSA screening with digital rectal examinations appears to increase the number of patients who are diagnosed with early prostate cancers.