[Watchful waiting for elderly patients with localized prostate cancer]

Watchful-waiting policy is an important treatment option for some patients with localized prostate cancer and it is widely recognized in Western countries in which the prostate cancer mortality rate is 510 fold higher than that in Japan. Most men with well and perhaps moderately differentiated prostate cancer who have a life expectancy of less than 10 years will die of other causes and it is not clear whether early primary hormone therapy improves survival and the quality of life compared to androgen suppression deferred until signs and symptoms of clinical progression. There is one major question as to whether patients who do not need radical treatment should undergo early primary hormone therapy in Japan in spite of high cost and treatment-related adverse effects of hormone therapy.