In general, localized cancer is best treated with surgical removal of the prostate gland or radiotherapy. Depending on the specific situation, radical prostatectomy, radiotherapy or watchful waiting (observation) will be the most appropriate management option. Furthermore, treatment decisions are difficult to make because of the generally indolent nature of prostate cancer and because it tends to occur in older men who often have multiple, competing medical illnesses. Even though prostate cancer is responsible for 40,000 deaths per year, screening programs are a matter of controversy because scientific evidence is lacking that early detection decreases morbidity and mortality. In the United States, prostate cancer is the most common solid tumor malignancy in men and second to lung cancer as the leading cause of cancer deaths in this group.
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