Counseling patients about therapy for localized prostate cancer

The major therapeutic approaches to localized prostate cancer are radical prostatectomy, external beam radiation therapy, and surveillance or observation. The appropriate treatment for a specific patient depends on tumor stage, grade, and prostate-specific antigen (PSA) level, as well as on patient age, medical status, life expectancy, and patient preference. A patient with localized prostate cancer should understand the nature of these therapeutic approaches and their possible complications. In the absence of good long-term outcome data, patient preference is a significant factor.