Counseling patients with newly diagnosed prostate cancer

Almost 200,000 men are diagnosed with localized prostate cancer each year. With the burgeoning number of treatment options for this disease, the number of patients seeking second opinions from an increasing variety of medical specialties will continue to increase. In 1999 (and for the foreseeable future), there is no single best treatment for any given patient--only options. Each treatment choice has a variety of advantages, as well as a unique spectrum of complications and side effects, most of which are poorly quantified and difficult to compare among treatments. Much more objective data are available regarding the efficacy and necessity of staging tests for further evaluation of patients after diagnosis. Current information about both staging and treatment alternatives, discussed in this article, should be part of the knowledge base of all physicians treating patients with prostate cancer.