A number of options are available to treat localised prostate cancer, with different side effect profiles, effect on quality of life and social costs.
This article outlines the grading and staging of localised prostate cancer and explores the role of each of the treatment options currently available.
Treatment selection in localised prostate cancer depends on life expectancy and comorbidities, risk adapted assessment and patient preference. Risk assessment depends on the grade, stage and prostate specific antigen. Options for treatment of localised prostate cancer include active surveillance, radical prostatectomy, curative external beam radiation therapy and brachytherapy. Androgen deprivation therapy in combination with radiation therapy has been shown to increase survival in men with high and high/intermediate risk of occult metastases. Survival rates are essentially equivalent for each modality and are over 90% at 10 years and over 75% at 15 years.
Prostate cancer is the most commonly diagnosed cancer in men, with over 19 000 cases diagnosed in Australia in 2007.1 The majority of men have minimal or no local symptoms, and have disease localised to the prostate or immediately surrounding tissues (locally advanced), determining the T stage (Figure 1).2 Nodal and distant metastases represent advanced disease. This article focuses on localised prostate cancer; treatment of advanced disease is beyond the scope of this article.
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