Prostate cancer is the most common cancer other than skin cancer in North American men and it is the second leading cause of cancer deaths in men. In some cases, prostate cancer occurs in a highly aggressive form that invades the body quickly; however, in many cases, it grows slowly and does not require immediate aggressive treatment. Instead, some early-stage, slow-growing prostate tumors can be managed effectively with a program of active surveillance that involves prostatespecific antigen testing, digital rectal exams, and periodic biopsies of the prostate. Several different methods of calculating prostate cancer risk have been developed that rely on prostate-specific antigen testing and the analysis of biopsy samples. Although these methods often provide useful information, they have inaccuracies that result in undertreatment of some patients and overtreatment of others. Since the available methods for predicting prostate cancer risk have uncertainties, decisions regarding treatment of new or recurrent prostate cancer factor in patient
age and health status, with a tendency to treat the disease more aggressively in patients who are younger and healthier.