TREATMENT OF LOCALIZED PROSTATE-CANCER - CHOOSING THE BEST ALTERNATIVE

Opinions among national experts vary regarding the best treatment for organ-confined prostate cancer, and the medical literature offers litt le evidence to support one option over another. For patients 70 years of age or younger who have a low Gleason score and a low prostate-spec ific antigen level, surgery is the preferred treatment; however, radia tion therapy may be an almost equivalent second choice, depending on t he patient's concerns about preserving potency. For patients over age 70, radiation therapy is preferred, and the approach used may vary amo ng medical centers. For the hypothetical 70-year-old patient described in this article, the optimal treatment is controversial. Consideratio ns include the expertise of the physicians involved and the patient's willingness to tolerate unpleasant side effects, Fortunately, long-ter m control is highly likely with any of the available treatments.