RT Journal Article SR Electronic T1 What's a man to do? Treatment options for localized prostate cancer. JF Canadian Family Physician JO Can Fam Physician FD The College of Family Physicians of Canada SP 65 OP 72 VO 50 IS 1 A1 Tom Pickles YR 2004 UL http://www.cfp.ca/content/50/1/65.abstract AB OBJECTIVE To describe treatments for localized prostate cancer: surgery, external radiation therapy, and brachytherapy; watchful waiting might also be appropriate. Patients trying to decide about treatment ask family physicians for advice. This article sets out a framework to aid patients (and physicians) in the decision. QUALITY OF EVIDENCE Only two randomized studies comparing different treatments were identified. Because of the paucity of level I or II evidence, suggestions in this review are largely based on expert opinion and consensus statements. MAIN MESSAGE Risk-grouping and nomograms are useful for assessing treatments and estimating outcomes of treatment. Where treatments are equivalent, decisions can be based on perception of toxicity and convenience. Effects on patients'lives and on sexual, urinary, and bowel function vary by treatment modality. CONCLUSION Men with low-risk prostate cancer should decide on treatment based on their perception of how treatment will affect their lives. Men with higher-risk cancers might accept adverse effects on their quality of life in return for longer survival.