Counseling the patient with localized prostate cancer

To provide a perspective on issues in counseling the patient about treatment options for localized prostate cancer.

Review factors contributing to the uncertainty in the decision for optimal therapy for an individual with localized prostate cancer.

There remains considerable debate relative to the need for aggressive therapy in many patients with prostate cancer, and no single therapy is universally viewed as effective. Multiple treatment options are available, including established ones, such as radical prostatectomy or external radiation therapy, and investigational ones, such as cryosurgery, implant radiation therapy, or adjuvant hormonal treatment. Multiple opinions are readily provided by physicians, friends, relatives, and others. It is valuable to strive to find the "best" treatment in an individual patient based on age, medical realities, and a patient's personal preferences. Throughout the entire process, it is important to maintain a positive, hopeful attitude to support the patient, irrespective of his choice for therapy.

Considerable uncertainty exists relative to the ideal therapy for a patient with prostate cancer. Counseling the patient requires providing balanced information to allow a patient to participate in this often difficult decision.