♦ Co-morbidity not significant
♦ Consider radical local therapy —prostatectomy
—radiotherapy
♦ Staging lymph node dissection, may be done laparoscopically
♦ Surgery may be better long-term for local control but effect on survival is uncertain
♦ High dose of conformal radiotherapy or brachytherapy may be as good
♦ Complications
—radical prostatectomy: 50% impotence; 8-15% long-term incontinence
—radical radiotherapy: 40% impotence; rectal stricture/bladder irritation but no incontinence
♦ Patients over 70 years —'wait and see' policy
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