If you’ve been diagnosed with prostate cancer, you likely expect to be treated with radiation or surgery. But for certain men and some tumors, guidelines recommend careful monitoring instead of intensive procedures that carry the potential for significant side effects.

When you’re deciding how to approach treatment, it’s important to discuss the risks and benefits of all options with your doctor so you can decide together, said Timothy Daskivich, MD, chief of Urologic Oncology Research at Cedars-Sinai.

“Your interaction with your doctor is largely going to determine treatment decisions,” Daskivich said. “Good communication will create a conversation that results in better choices.”

Read: More Options to Treat Prostate Cancer

Prostate cancer is among the most common cancers in men in the U.S. Active surveillance—careful monitoring with selective intervention for progressive disease—is the most common treatment for low-risk prostate cancer, which grows slowly and is not likely to cause symptoms or spread to other organs.

But in a recent study, Daskivich and Cedars-Sinai colleagues found that older men continue to be treated with surgery and radiation for higher grade tumors, even when they are unlikely to live long enough to benefit from such treatments—and despite guidelines recommending against treatment.

“Doctors don’t want to see patients harmed by cancer, even if there’s a low likelihood of benefit,” he said. “But clinicians should discuss longevity with prostate cancer patients so they can make educated choices about treatment.”

Read: Study: Older Prostate Cancer Patients Are Increasingly Being Overtreated

If you’ve been diagnosed with prostate cancer, here are three things to consider discussing with your doctor.

In another study published in 2022, Daskivich found that 88% of patients want to know their life expectancy. But in a different study, he found doctors often don’t mention life expectancy, or don’t quantify it.

“Though there are complex nuances to life expectancy prediction, and doctors may want to avoid offering absolutes, patients need a frame of reference for whether they are likely to live long enough to benefit from treatment as they make decisions,” he said.

For some men, treatment can be lifesaving, while for others, it may not extend lifespan. Either way, surgery and radiation cause side effects such as erectile dysfunction and urinary incontinence. Active surveillance involves regular monitoring with blood tests and periodic MRIs and biopsies of the prostate.

“You have to weigh the side effects of different treatment options to see which is most acceptable to you,” Daskivich said.

Engage with your doctor about what is important to you. Some patients want to extend their life at all costs, and others want to prioritize and preserve their quality of life. If you aren’t sure how to balance your risks, your doctor can offer guidance so you can make the best choice.

“Different patients have different priorities,” Daskivich said. “Deciding how to treat cancer requires balanced conversations between doctors and patients. Not every patient with limited longevity is going to decide against treatment, even with limited benefit. And that’s OK, as long as the patient is basing that decision on good data.”