Deciding on radical prostatectomy: the physician's perspective

Patients and physicians often face a difficult process in determining which treatment option to pursue for localized prostate cancer. Observation, hormonal therapy, cryotherapy, various forms of radiation therapy, and surgery all may be offered as options depending on many factors, such as age, the patient's overall health, clinical stage, and opinions of both the physician and the patient. In the information age of computers and the new openness about prostate cancer, a wealth of data can be obtained by the patient, the patient's family, and the physician on these various modalities. This article focuses on the role of surgery as a primary treatment modality for clinically localized prostate cancer from the urologist's prospective. The indications, the merits of retropubic versus perineal, and the reported morbidity and mortality associated with radical prostatectomy are discussed. The procedure is also compared with conservative management and radiation as treatment modalities for localized prostate cancer.