Prostate Cancer

Approximately 185,000 men will be diagnosed with prostate cancer in the US in 2009. If you have a basic knowledge of the different treatment options available you will better prepared to discuss the options with your doctor.
A recent survey of doctors by the New England Journal of Medicine found that doctor's preference for treating prostate cancer is generally evenly divided between three treatments: Surgery, Radiation Therapy, and continuing to monitor the cancer. The good news is the treatment of early stage prostate cancer results in a 90% cure rate, no matter which treatment is performed.
Prostatectomy
Men diagnosed with prostate cancer in their 40s and 50s are typically steered toward surgery to remove the prostate, a procedure called a prostatectomy. Radical prostatectomy is generally effective in treating prostate cancer that has not spread. There is a some risk of side effects with surgery including problems with urination and sexual performance. 80% of men experience sexual performance problems after a prostatectomy, however most eventually regain their ability to perform. 76% of men below the age of 60 regain their ability to sexually perform, and about 50% of men over the age of 60.
Radiation Therapy
Older men, men with other health problems, and those whose cancer has spread beyond the prostate are typically counseled to have radiation therapy. Radiation therapy has fewer immediate side effects, however long term side effects can be caused by damage to the prostate caused from the radiation. A degree of uncertainty goes along with radiation treatment. Since the prostate gland and the lymph nodes are not taken out, your doctor can't tell the exact size of the tumor. The cancer could come back many years after radiation treatment. At 10 years after treatment, cure rates are about the same for radiation therapy and radical prostatectomy.
Monitoring Only
About 50% of men diagnosed with prostate cancer in the US have a low grade form that does not require immediate treatment and may never need treatment. Because many men with a slow-growing tumor have the same life expectancy as men who don't even have prostate cancer, it may not be necessary to treat very small, very slow-growing prostate tumors. Also, some men feel that the side effects of treatment outweigh the benefits. In watchful waiting, you get no treatment, but you see your doctor often. If there's no sign the cancer is growing, you continue to get no treatment. The risk of monitoring only is that the cancer can progress from an highly curable early stage to a more advanced stage that is more difficult to treat. Men who chose the monitoring option have to be actively engaged and stick to the scheduled PSA tests and other tests recommended by their doctor. Only about 10% of men diagnosed with slow growing prostate cancer chose the monitoring only option due to the negative psychological effects of having untreated cancer.
The American Cancer Society guidelines recommends PSA tests starting between 40 and 50 years of age, depending on your family cancer history. The earlier prostate cancer is detected the higher your odds are of survival.