Untreated Prostate Cancer

How the disease will progress if you opt for no medical intervention

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Untreated prostate cancer can spread to other parts of the body. If you choose not to treat prostate cancer, which is your right, your healthcare provider will still monitor your disease and may offer treatments to help ease symptoms. 

This article goes over the decision not to treat prostate cancer and what to expect if you choose to go this route.

The Decision Not to Treat Prostate Cancer

Decisions about prostate cancer treatment are based on your needs and preferences. There is no "right choice" for every person. Many factor in the opinions of both their healthcare team members and loved ones. But ultimately, the choice is yours.

Once your provider has taken a biopsy and looked at the sample of your tumor under a microscope, they'll have important information that will help them make their recommendation about what to do next.

Some choose to start treatment soon after diagnosis. Others may opt for active surveillance, which only involves monitoring the cancer.

Active Surveillance

Choosing to just watch prostate cancer instead of treating it right away is common when the cancer is:

  • Small and expected to grow slowly
  • Only in the prostate
  • Not causing any symptoms

In active surveillance for prostate cancer, treatment will only be started if your cancer starts to grow—and you give the green light for medical intervention.

Declining Treatment

Other people choose not to have cancer treatment at all. They may make this decision because they:

  • Are not expected to live for very long
  • Have other serious medical problems

In these cases, they may feel that the risks or side effects of cancer treatments like surgery and radiation outweigh the potential benefits.

If you decide not to have cancer treatment, your provider may talk to you about treatments for any symptoms you're having. Palliative care and hospice care might be options, depending on your life expectancy and needs.

Doctor explaining anatomical model to patient in hospital
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What Happens If I Don't Treat Prostate Cancer?

Cancer is easiest to treat when it is just in the prostate. At this early stage, surgery and radiation are most likely to completely kill or remove any cancer cells that are there and cure the disease.

Prostate cancer is often found while the cancer is still only in the prostate and has not spread to other parts of the body. This is called “local disease” or “localized disease.”

If you decide not to treat prostate cancer, your provider may talk to you about the typical progression of the disease when it goes untreated. This timeline is sometimes called a disease's "natural history" and it walks you through the various stages of prostate cancer.

Where Prostate Cancer Spreads

If left untreated, prostate cancer can grow and possibly spread (metastasize) to nearby tissues or farther away to other sites in the body. The first sites of spread are typically the tissues around the prostate.

Cancer can also spread down the blood vessels, lymphatic channels, or nerves that go in and out of the prostate. Cancer cells can enter the blood vessels and lymphatic channels. Once prostate cancer has gotten inside these vessels, the cells can “seed” in almost any part of the body.

Cancer can also make its way through the capsule that surrounds the prostate. The seminal vesicles are another very common site for early spread. More intense local spread can happen when the cancer cells get inside nearby organs like the bladder or rectum.

Prostate cancer is known for spreading to the bones, especially the lower spine, pelvis, and femur. Prostate cancer can also spread to the liver, brain, or lungs, though that is less common.


Untreated prostate cancer can grow and spread to other parts of the body. If you have prostate cancer and choose not to have treatment, your provider will still keep an eye on your health and may offer you treatments for your cancer symptoms to help you be more comfortable. 

Prostate Cancer Healthcare Provider Discussion Guide

Get our printable guide for your next healthcare provider's appointment to help you ask the right questions.

Doctor Discussion Guide Man
5 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. American Cancer Society. How is prostate cancer treated?.

  2. Prostate Cancer Foundation. Palliative care for advanced prostate cancer.

  3. National Cancer Institute. Cancer stat facts: prostate cancer.

  4. Soylu FN, Peng Y, Jiang Y, et al. Seminal vesicle invasion in prostate cancer: evaluation by using multiparametric endorectal MR imaging. Radiology. 2013;267(3):797-806. doi:10.1148/radiol.13121319

  5. Wong SK, Mohamad NV, Giaze TR, Chin KY, Mohamed N, Ima-Nirwana S. Prostate cancer and bone metastases: The underlying mechanismsInt J Mol Sci. 2019;20(10):2587. Published 2019 May 27. doi:10.3390/ijms20102587

By Matthew Schmitz, MD
Matthew Schmitz, MD, is a professional radiologist who has worked extensively with prostate cancer patients and their families.