Patient counseling regarding treatment of T1/2 (A/B) prostate cancer. A personal view

Mr. Smith, a healthy 67-year-old man, has a "routine" prostate-specific antigen (PSA) of 7 ng/ml by Hybritech assay. No prostate abnormality was appreciated by digital rectal exam. Sextant biopsy revealed three cores positive for 3 + 3 Gleason sum with an area of pattern 4. A bone scan was normal. The patient has no prior history of genitourinary disease, is continent, and is potent. I will review necessary background information concerning the therapy available for localized prostate cancer with Mr. Smith so that together we can identify the option most suited to the stage and grade of his disease, his general health, and his attitude or disposition to therapeutic interventions.