With the advent of the prostate-specific antigen (PSA) test in the 1990s, the lifetime risk of being diagnosed with prostate cancer in the United States has nearly doubled to twenty percent. However, the risk of dying of prostate cancer remains at approximately three percent. Once prostate cancer has been diagnosed, the decision on the best course of treatment can be complex. Numerous factors can influence the decision on how to proceed, including that some prostate cancers grow so slowly they would likely never cause significant problems during a patient’s lifetime. The adverse effects of the available interventions and how they affect quality of life must also be considered.