Whether prostate cancer needs immediate treatment depends on how aggressive the cancer is. Currently, doctors are very well equipped to be able to tell based on clinical data, your PSA, how much cancer is found on the biopsy, the grade or aggressiveness of the cancer, which is called the Gleason score. All of those factors put together can give a very clear picture as to whether your cancer may never progress or harm you. When the cancer seems like the aggressiveness level is very low, only close monitoring is required. This is called active surveillance. The whole point of active surveillance is that we don’t want to disturb a man’s quality of life to treat a cancer that itself was never going to be a threat. If over time, the cancer appears to be changing, where there are more aggressive components, then treatment can be initiated later where the chance of cure is still extremely high. If, on the other hand, at diagnosis the cancer seems more aggressive. Then immediate treatment usually is recommended.