When evaluating the impact of a screening program, researchers and public health officials must weigh not only the benefits of the program but also the potential harm that follows the introduction of the program. Unfortunately, little information is available from clinical trials that support the efficacy of intervention. Several publications have documented the complications associated with intervention, including the risk of incontinence bowel irritation and impotence. Decision analyses of screening have suggested that quality-adjusted survival may be compromised by screening, while decision-analytic models question the ability of screening and treatment to alter the outcome among men aged over 70, especially those with well- and moderately differentiated disease.

The management of localized prostate cancer remains one of the most controversial areas in urological oncology. While long-term survival is expected regardless of the initial treatment strategy, the probability of cure remains less than desirable. With an increasing number of patients diagnosed with localized at an earlier age, the issue of curability has become even more relevant. Long-term survival is no longer considered an adequate measure of success. In this review, we look at recent advances in radiation therapy of localized prostate cancer and their impact on the outcomes in this disease.