Treatment of prostate cancer: Watchful waiting, radical prostatectomy, and cryoablation

Current advances in diagnostic modalities and screening has lead to diagnosis of prostate cancer at an earlier stage (the so-called "stage shift" phenomenon), making primary treatments of localized disease of extreme importance in management. Therapeutic modalities include conservative management, radical prostatectomy, external beam radiotherapy, and newer techniques such as cryoablation surgery and brachytherapy. This review will focus on the non-radiation, non-hormonal primary treatment of localized prostate cancer and discuss the popularity and success of "watchful waiting," radical surgery, and cryoablation along with their advantages and disadvantages. These treatments will be compared to the qualities of an ideal treatment, which include cost effectiveness, efficacy, convenience of administration, tolerance by patients, low morbidity and mortality, and minimal impact on quality of life.