Defining the role of surveillance in the management of localized prostate cancer

The management of localized prostate cancer continues to be controversial because of the absence of randomized studies. The existing literature demonstrates the surveillance therapy, which means no initial local therapy, is a reasonable option, risks and benefits considered, for men with this disease. It is most appropriate for men with well- or moderately differentiated cancer and a life expectancy of 10 years or less. All men, however, should be presented with the outcomes of this approach so that an informed choice can be made that best suits each patient's own goals.