Any discussion of the future of medicine should include a discussion of prostate cancer surgery, which is presently one of the most rapidly evolving and technologically advanced areas of medicine. Prostate cancer is the most common cancer in men for which the surgical treatment is radical prostatectomy (RP). RP affords a high chance of cure for localized prostate cancer and has a demonstrated survival benefit. RP has been around for more than a century and has undergone a dramatic evolution culminating in modern techniques that allow for excellent oncologic control and quality of life. A variety of surgical approaches exist for RP including open, laparoscopic, and laparoscopic with robotic assistance. Outcomes, cost, learning curves and usage trends for these approaches are discussed. Other therapeutic options including watchful waiting, active surveillance, external beam radiation therapy, brachytherapy, cryotherapy and high frequency ultrasound are also briefly discussed.
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