title: Treatment options for localized prostate cancer.
abstract: OBJECTIVE
  To describe treatment options for clinically localized prostate cancer: radical prostatectomy, prostate brachytherapy, external beam radiation, and active surveillance.
  
  
  METHODS
  Prostate-specific antigen (PSA) outcomes presented are from non-randomized, cohort, and other comparisons trials (level II evidence). We describe PSA outcomes from Canadian centres when they are available. One small randomized controlled trial (level I evidence) in localized prostate cancer is available to compare radical prostatectomy with brachytherapy.
  
  
  RESULTS
  Treatment choice in prostate cancer is based on initial PSA level, clinical stage of disease, and Gleason score, together with baseline urinary function, comorbidities, and patient age. In this article, we describe patients' eligibility for and the common side effects of all treatment options. Prostate brachytherapy and active surveillance have evolved as new standard treatments of localized prostate cancer. We give a brief overview of the brachytherapy procedure, side effects, and PSA outcomes across Canada, as well as active surveillance guidelines.
  
  
  CONCLUSIONS
  Prostate cancer treatment requires a multidisciplinary approach, with input from both urology and radiation oncology. Input from family physicians is often as important in helping guide patients through the treatment decision process.
authors: Prostate Brachytherapy Program, BC Cancer Agency, 600 W 10th Ave, Vancouver, BC V5Z 4E6. mkeyes@bccancer.bc.ca.
authors: Mira
authors: M
authors: Keyes
authors: Juanita
authors: J
authors: Crook
authors: Gerard
authors: G
authors: Morton
authors: Eric
authors: E
authors: Vigneault
authors: Nawaid
authors: N
authors: Usmani
authors: W James
authors: WJ
authors: Morris
mesh_terms: D001918:Brachytherapy; D019317:Evidence-Based Medicine; D005194:Family Practice; D006801:Humans; D008297:Male; D010819:Physician's Role; D017430:Prostate-Specific Antigen / Q000097:blood; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000097:blood / Q000628:therapy*; D057832:Watchful Waiting
chemical_list: D017430:Prostate-Specific Antigen