--- title: I've been diagnosed with prostate cancer. Can it be watched instead of treated? publication: Medical Insights Korea section: faq category: Prostate Cancer canonical_url: https://medicalinsightskorea.com/faq/can-my-prostate-cancer-be-watched-instead-of-treated author: Catherine Cho published: 2026-10-05T11:00:00+09:00 modified: 2026-10-05T11:00:00+09:00 content_type: reference license: Quotation permitted with attribution to Medical Insights Korea and a link to the canonical URL. --- # I've been diagnosed with prostate cancer. Can it be watched instead of treated? For about a quarter of Korean patients, yes — and that is the ceiling, not the average. Which quarter you are in depends on the biopsy, not on preference. ## Answer Active surveillance is an option for roughly a quarter of Korean patients: among 27,075 men with biopsy-confirmed prostate cancer across 51 Korean hospitals, 6,586 (24.3 percent) were eligible under a deliberately maximised definition counting low risk, potentially low risk and favourable intermediate risk together — eligibility that fell from 27.6 percent in 2010 to 22.0 percent in 2020, and that ranged from 16.9 percent in Chungbuk to 29.3 percent in Gyeonggi — while under the narrower low-risk-only definition the figure is 5.45 percent. ## Key takeaways - Among 27,075 Korean men with biopsy-confirmed prostate cancer, 24.3 percent were eligible for active surveillance under a maximised definition. - Under the narrower low-risk-only definition the eligible share is 5.45 percent, with another 4.00 percent potentially low risk. - The risk distribution was 5.45 percent low, 4.00 percent potentially low, 14.88 percent favourable intermediate, 21.72 percent unfavourable intermediate and 53.94 percent high risk. - Eligibility fell from 27.6 percent in 2010 to 22.0 percent in 2020 (p < 0.001). - Across 17 administrative districts eligibility ranged from 16.9 percent to 29.3 percent (p < 0.001). - Urban areas had higher eligibility than rural ones, at 26.4 against 20.5 percent. - Eligibility is calculated from PSA, clinical stage, Gleason grade group and biopsy core involvement — features of the tumour, not of the patient's wishes. ## Full article Active surveillance means being monitored with PSA tests, examinations and repeat biopsies rather than being treated, with treatment held in reserve if the cancer changes. Whether it is available to you is decided by what the biopsy showed, and Korean national data now says how often that answer is yes. **24.3%** — of 27,075 Korean men with newly diagnosed prostate cancer were eligible for active surveillance under a maximised definition _Source: Ko YH et al., Prostate International, 2026_ ### Why 24.3 percent is a ceiling The researchers deliberately drew the definition as wide as the evidence allows, counting favourable intermediate-risk disease as eligible alongside low and potentially low risk. Under the narrower definition most guidelines used historically — low risk alone — the figure would be 5.45 percent. That matters when you are given the number. One in four is the most generous reading of who could be watched, not the typical case. More than half of Korean prostate cancer, 53.94 percent, is high risk at diagnosis, and surveillance is not an option for it. > **Where you live changes the odds** > Eligibility ranged from 16.9 percent in Chungbuk to 29.3 percent in Gyeonggi, and from 26.4 percent in urban areas to 20.5 percent in rural ones. This is not a difference in how urologists think about surveillance. Eligibility was calculated from the tumour — PSA, stage, Gleason grade and how much of each biopsy core was involved — so a man outside the capital region is less often eligible because his cancer is further along when it is found. ### The trend is going the wrong way Eligibility fell from 27.6 percent in 2010 to 22.0 percent in 2020. In a decade when testing became more available, not less, you would expect the opposite: more testing usually finds more small, slow cancers, which means more men who can be watched. Korea moved the other way, which points at detection happening later rather than earlier. ### What to ask The useful questions are specific: what is my Gleason grade group, what is my clinical stage, what proportion of the biopsy cores were involved, and does that put me in the low, favourable intermediate, or higher risk category. Those four answers determine whether surveillance is on the table, and they are all already in your pathology report. One structural caveat on the data: the cohort covers 37.9 percent of nationally reported cases, abstracted from hospitals with 200 or more beds, so it is a large sample rather than a complete census. ## Sources - Ko YH, Kim SW, Son NH. Active surveillance could apply to one-quarter of Korean prostate cancer cases: Insights from a 27,075-patient cohort. Prostate International 2026;14(2):127-131. doi:10.1016/j.prnil.2025.12.004. PMID:42382553. https://doi.org/10.1016/j.prnil.2025.12.004 - Ko YH, Kim SW, Son NH. Incidence of High-Risk Prostate Cancer in Korea: Insights From Real-World Data Between 2010 and 2020. Journal of Korean Medical Science 2026;41(14):e10. doi:10.3346/jkms.2026.41.e10. PMID:41978922. https://doi.org/10.3346/jkms.2026.41.e10 ## Citation Catherine Cho (2026). "I've been diagnosed with prostate cancer. Can it be watched instead of treated?". Medical Insights Korea. https://medicalinsightskorea.com/faq/can-my-prostate-cancer-be-watched-instead-of-treated Retrieved from https://medicalinsightskorea.com/faq/can-my-prostate-cancer-be-watched-instead-of-treated