First-line treatments for early stage (localized) prostate cancer

There are a range of possible options for the initial treatment of localized prostate cancer, and yes, you are going to have to make a choice! They include all of the following:

It is important for patients to understand that the vast majority of these forms of treatment have never been compared to each other in large, well structured, randomized clinical trials, and they probably never will be for the simple reason that the vast majority of patients are (perhaps rightly) unwilling to be told at random that they are going to get (for example) external beam radiotherapy for 8 weeks compared to minimally invasive surgery.

The downside of this reality, of course, is that (at least at present) we simply do not know whether, in most cases, any one of these techniques is any more effective in the long term than any other for the treatment of prostate cancer in patients with specific subsets of early stage disease. There are now two, preliminary exceptions to this general statement.

There is, however, one generally accepted truism. Whatever form of treatment you decide to select, the single most important thing is to make sure, if at all possible, that it is done by a physician (or by a team of specialists in the case of external beam radiation therapy) who is highly skilled at the treatment of prostate cancer using the specific treatment type that you have selected. In this way you will almost certainly minimize your risk for the possible complications associated with that form of treatment … and every single one of the above forms of management (with the exceptions of watchful waiting and active surveillance) does come with significant risk for side effects and complications.

Content on this page last reviewed and updated December 23, 2008.
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