Cancer Prostate Cancer What Happens When Prostate Cancer Is Left Untreated By Matthew Schmitz, MD linkedin Matthew Schmitz, MD, is a professional radiologist who has worked extensively with prostate cancer patients and their families. Learn about our editorial process Matthew Schmitz, MD Medically reviewed by Medically reviewed by Doru Paul, MD on November 04, 2019 Doru Paul, MD, is triple board-certified in medical oncology, hematology, and internal medicine. He is an associate professor of clinical medicine at Weill Cornell Medical College and attending physician in the Department of Hematology Oncology at the New York Presbyterian Weill Cornell Medical Center. Learn about our Medical Review Board Doru Paul, MD Updated on November 19, 2019 Print Prostate Cancer Overview Symptoms Causes Diagnosis Treatment Coping While most men undergo some form of treatment for their prostate cancer, some men today choose to not be treated for their prostate cancer. Instead, they may choose to have their doctors monitor their cancer, especially if it's expected to grow slowly based on biopsy results, confined to the prostate, not causing any symptoms, and/or small. This is called active surveillance, meaning doctors will initiate cancer treatment only if cancer starts growing. Others choose no cancer treatment because of a short life expectancy or other serious medical problems. They may feel that the risks or side effects of cancer treatment (like surgery and radiation) outweigh their potential benefits. This option is certainly OK and reasonable in the right circumstances—requiring a careful and thoughtful discussion with your doctor and family. What Happens If Prostate Cancer Is Left Untreated Physicians will sometimes talk about a particular disease’s “natural history” or typical progression if it is left untreated indefinitely. With regard to prostate cancer, most cases of the disease are discovered while the cancer is still confined to the prostate itself. This is called “local disease” or “localized disease.” The disease is easiest to treat while it is confined to the prostate. At this stage, surgery and radiation are most likely to be curative and completely kill or remove whatever cancer cells are present.If left untreated, however, prostate cancer can proceed on a number of different paths. Where Prostate Cancer Spreads If left untreated, diagnosed prostate cancer can grow and possibly spread outside of the prostate to local tissues or distantly to other sites in the body. The first sites of spread are typically to the nearby tissues. The cancer can spread down the blood vessels, lymphatic channels, or nerves that enter and exit the prostate, or cancer could erode directly through the capsule that surrounds the prostate. The seminal vesicles are a site of particularly common early spread. More extensive “local” spread can occur with cancer invading the nearby bladder or rectum. Further advancement of cancer can occur when cancer cells enter the blood vessels and lymphatic channels. Once cancer has entered into these vessels, prostate cancer cells can “seed” into virtually any other part of the body. Prostate cancer is known to have a particular affinity for spreading or metastasizing to the bones especially the lower spine, pelvis, and femur. Other organs such as the liver, brain, or lungs can also be the sites of spread, but these are much rarer. Prostate Cancer Prognosis Can Vary by How It Has Spread A Word From Verywell Prostate cancer is a complicated disease and requires extremely careful thought when determining the best treatment option (for yourself or your loved one). There are a number of available therapies and not necessarily a single best fit—so seek the guidance of your doctor, and don't be afraid to get a second opinion. Prostate Cancer Doctor Discussion Guide Get our printable guide for your next doctor's appointment to help you ask the right questions. Download PDF Email the Guide Send to yourself or a loved one. Sign Up This Doctor Discussion Guide has been sent to {{form.email}}. There was an error. Please try again. Was this page helpful? Thanks for your feedback! Limiting processed foods and red meats can help ward off cancer risk. These recipes focus on antioxidant-rich foods to better protect you and your loved ones. Sign up and get your guide! Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit Article 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. Garisto JD, Klotz L. Active surveillance for prostate cancer: how to do it right. Oncology (Williston Park, NY). 2017;31(5):333-40, 345. National Cancer Institute, Surveillance, Epidimeology, and End Results Program. Cancer stat facts: prostate cancer. Updated April, 2019. 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 Jin JK, Dayyani F, Gallick GE. Steps in prostate cancer progression that lead to bone metastasis. Int J Cancer. 2011;128(11):2545-61. doi:10.1002/ijc.26024 Additional Reading American Cancer Society. (2016). How is prostate cancer treated?