What is the treatment for low-risk prostate cancer?

For many patients with low-risk prostate cancer, close observation with regular monitoring of prostate-specific antigen (PSA) levels and no immediate treatment (sometimes termed active surveillance) is an excellent option. In general, patients who are older and/or in poor health with a high risk of dying of other diseases within the 10 to 15 years following their prostate cancer diagnosis are poorly served by aggressive treatment. Sometimes this concept is difficult for patients in the United States to comprehend. They hear the word "cancer" and want it treated yesterday. In Europe, however, the mind-set must be quite different, since patients choose this option for low-risk disease quite frequently. Several major trials have revealed that not treating prostate cancer immediately is a reasonable option for men with low-risk disease. Most urologists recommend reevaluation with PSA in this setting more frequently than annually. A common schedule would be a repeat PSA test every three to six months. Men who are very elderly or ill and wouldn't ever want or qualify for treatment shouldn't have their PSA tested at all. This decision makes common sense.

There are multiple excellent treatment options for men with low-risk prostate cancer. These include radical prostatectomy (surgery to remove the prostate), brachytherapy (radiation delivered over a short distance), and definitive external beam radiation therapy (RT). Other treatments which are currently nonstandard or have less information available about long-term cure rates include cryotherapy (freezing the prostate tissue) and high-frequency ultrasound (HiFU).