Localised and Locally Advanced Prostate Cancer: Who to Treat and How?

Prostate cancer is the third most common cause of male death in Europe. In 2004, prostate cancer accounted for 85,200 deaths, equating to 8.9% of all male cancer deaths. In recent years, heightened awareness of the disease and increased prostate-specific antigen screening have resulted in an overall rise in the incidence of prostate cancer detection, with more young men presenting with earlier stage (ie, localised or locally advanced) disease. For many patients diagnosed with prostate cancer, especially for those who wish to maintain an active life, quality of life is of paramount importance. The challenge, therefore, is to identify which patients will benefit most from the different treatment options available. In this article we present two clinical scenarios to facilitate discussion of the treatment options available for two patients-one with localised disease and another with asymptomatic locally advanced disease-who are both anxious to avoid death from prostate cancer.