For a man newly diagnosed with prostate cancer, the most bewildering news may the need to choose among an array of treatment options.

The principal choices for a person whose cancer is confined to the prostate gland, or localized, range from surgery (a prostatectomy), to two different types of radiation therapy (external beam radiation or brachytherapy), or to simply monitoring the disease to see if symptoms appear (watchful waiting).

Yet another treatment option that uses liquid gas to freeze and kill prostate cancer cells, cryosurgery, has shown some promise but while no longer experimental, is still considered an alternative therapy.

Not only is there no one-treatment-fits-all approach that is the right choice for all men; there also are no results available from clinical trials that directly compare outcomes for the various treatment options for men with similar stages of prostate cancer.

Among the factors that the National Cancer Institute says you should consider are:

• Is your cancer truly confined to the prostate gland, or has it spread to nearby-or even distant-parts of your body?
• Is it aggressive or slow-growing?
• What is your general health status?
• Are you young enough so that even a slow-growing cancer might someday pose a threat?
• Are you healthy enough for surgery?
• Are you willing to risk serious, lifelong side effects to possibly reduce your chances of a cancer death?
• How important is it for you, in your work or recreation, to maintain bladder or bowel control?
• How important is it to be able to have erections?
• Would you find it too worrisome to live with an untreated cancer, too stressful to face frequent monitoring?
  

Your answers to these questions hopefully will help you as you weigh the pros and cons of the various treatment options.

If your cancer has advanced beyond the prostate gland, or if it recurs and spreads to other parts of your body, radiation may be used to help to keep the cancer in check and hormonal therapy may slow its advance.

Another option for advanced disease is to enroll in a clinical trial and participte in the study of new treatments.