Onkológia 1/2026
Therapeutic options for localized prostate cancer and their comparison
Prostate cancer is the most common malignant tumor in men in Slovakia, with the majority of cases diagnosed at early, organconfined stages without metastases. Localized prostate cancers are classified as low, intermediate, and highrisk disease. This paper summarizes the available treatment options and their adverse effects that influence patients’ quality of life. Management strategies for localized prostate cancer include active surveillance, radical prostatectomy, external beam radiotherapy, brachytherapy, and stereotactic radiotherapy. Active surveillance is recommended for patients with lowrisk tumors and selectively for those with intermediaterisk disease. Radical prostatectomy is indicated for patients with intermediate and highrisk cancer, but may be associated with urinary incontinence and erectile dysfunction. In highrisk disease, combination therapy with radiotherapy and androgen deprivation therapy is often required. External beam radiotherapy, brachytherapy, and stereotactic radiotherapy are noninvasive treatment modalities that provide oncologic outcomes comparable to radical prostatectomy, with fewer bowel, urinary, and sexual adverse effects. Treatment selection should be individualized according to disease risk category and patientspecific factors such as age, comorbidities, and personal preferences. Comprehensive patient education regarding treatment options, expected outcomes, and potential adverse effects is an essential component of informed consent.
Keywords: localized prostate cancer, active surveillance, radical prostatectomy, radiotherapy, brachytherapy
