The three most common treatments for localized prostate cancer are expectant management, which includes active surveillance and watchful waiting, radiation therapy, and surgery.

• Active surveillance or watchful waiting is based on the recognition that some prostate cancers follow a non-aggressive course, and tend not to spread outside the prostate nor become life-threatening. PSA and a digital rectal exam need to be checked on a regular basis, and repeat prostate biopsies should be carried out at regularly scheduled intervals. If during the monitoring period, the cancer shows signs of growth or of becoming a more aggressive tumor, then treatment with surgery or radiation can be initiated.
• Radiation therapy, includes two types: interstitial prostate brachytherapy and external beam radiation therapy. With interstitial prostate brachytherapy, small radioactive “seeds” are planted in the prostate. The seeds deliver radiation energy to the prostate over the course of four to six months, which can “kill” the prostate cancer cells. Seed treatment is an outpatient-based procedure. External beam radiation therapy uses radiation delivered from an external source (an x-ray beam) to treat prostate cancer.
• Radical prostatectomy is the term used for surgery to remove the prostate. Surgery can be done through an open, laparoscopic or robotic technique. The term “radical” means that the entire prostate and nearby tissues are removed through surgery.

Other treatments, such as cryotherapy, have been used for the treatment of localized prostate cancer, but have not been widely used.