Prostate cancer is the most common cancer of an internal organ in U.S. males and the second leading cause of cancer death in U.S. men. The disease presents in a wide spectrum of grades and stages and many men with prostate cancer will not die of their disease. Today widespread prostate cancer screening with the prostate specific antigen blood test (PSA) and digital rectal examination (palpation of the prostate through the rectum), has shifted the classic presentation of this disease from bulky prostate cancers with widespread bone metastases to early stage tumors localized to the prostate gland (organ-confined prostate cancer). In addition, some prostate cancers are known to be slow-growing tumors while others harbor more aggressive characteristics. For these and other reasons men with prostate cancer often have many different treatment options from which to choose.
Traditional treatment of localized prostate cancer includes surgical removal of the prostate gland (robotic prostatectomy) or radiation therapy (external beam radiotherapy or brachytherapy). These treatments may be combined with a course of hormone therapy. Alternative treatments for localized prostate cancer may include active surveillance (serial biopsies of the prostate over months or years to monitor the cancer and elect more definitive treatment if there is evidence of cancer progression), and ablative or focal therapies, whereby prostate tissue is destroyed by freezing or heating the gland (i.e. cryotherapy or high-intensity focused ultrasound). These latter treatments may be available in specific instances only through participation in a clinical trial.