Of course it can be done, but will it? I don't think so, not while there are so many millions of dollars in play in creating anxiety about every facet of prostate cancer, from PSA testing/screening to the inappropriate tests and scans ordered, to the lack of clear indications of outcomes, to unneccesary adjuvant treatments (or should I say adjuvant treatments that have no demonstrable value … the list goes on. This anxiety drives men like beaters at a pheasant shoot, right into early treatment.

In the midst of all this gloomy outlook there is the faintest glimmer of light. I have personally experienced the change in attitude to what was called, so inappropriately, watchful waiting and which is now commonly referred to as active surveillance.

Thirteen years ago it was clear that the general view was that only fools and lunatics would consider such a step. The lunacy element has been removed now and men who follow this path, and the doctors who support that decisio,n are merely regarded as foolish. Perhaps as more time goes by and more studies are published, even that appellation might be removed.