¹James Buchanan Brady Urological Institute, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA

Correspondence: AW Partin, The Brady Urological Institute, The Johns Hopkins Medical Institution, 600 North Wolfe Street, Marburg 134, Baltimore, MD 21287, USA. E-mail: apartin@jhmi.edu

Received 25 June 2005; Revised 18 July 2005; Accepted 18 July 2005; Published online 30 August 2005.

Abstract

Localized prostate cancer demonstrates tremendous heterogeneity in the natural history of the disease. To this end, although prostate cancer may be present histologically in nearly 30% of all men above the age of 50 y, the lifetime risk of developing clinically significant disease is 18% (one in six). Furthermore, the lifetime risk of dying from prostate cancer is less than 4%. Therefore, in order to avoid unnecessarily treating potentially insignificant prostate cancer, the concept of expectant management has been considered for this disease. In this brief review, we discuss the evolution of expectant management for men with localized prostate cancer.