It should be emphasized that the old model of "watchful waiting" has been replaced here by "active surveillance," which may include a variety of monitoring modalities, including PSA trending, digital rectal exam and biopsy at intervals. It basically means studying the progression of the disease and only treating it when it's warranted. A study from Johns Hopkins found that fewer than 1% of men in an active surveillance program for diagnosed prostate cancer had meaningful progression of their disease 15 years later. That means that greater than 99% of those men were free from the complications and adverse effects of what would have turned out to be unnecessary treatment, including pain, incontinence, sexual dysfunction, and infection, not to mention expense. Yes, some prostate cancer is aggressive. Most, however, is fairly indolent, meaning that it smolders rather than bursting into flame; the man will die of other causes (or old age) before the cancer has a chance to advance that far.