{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,6]],"date-time":"2026-03-06T21:42:46Z","timestamp":1772833366008,"version":"3.50.1"},"reference-count":67,"publisher":"American Society of Clinical Oncology (ASCO)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am Soc Clin Oncol Educ Book"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:p>Current guidelines for clinically localized prostate cancer offer a wide range of management options, from active surveillance to surgery and radiation therapy (RT). Treatment selection depends on tumor characteristics, overall health, and patient goals. Advances in surgical and radiation techniques have improved survival and functional outcomes, yet treatment continues to have significant impacts on quality of life. Sexual, urinary, and bowel dysfunction are common, and psychological distress, including anxiety, depression, and decisional regret, frequently accompany survivorship. Patients must navigate complex trade-offs between disease control and functional or personal outcomes. This review explores the interplay between treatment options, functional outcomes, and psychosocial considerations in localized prostate cancer care. Key topics include patient priorities, surgical strategies to optimize functional outcomes of radical prostatectomy, advances in RT which improve precision and reduce toxicity, and the role of mental health and lifestyle in survivorship. Integrating these approaches into multidisciplinary care can support overall quality of life. Aligning treatment decisions with patient values and goals is essential for reducing decisional regret and supporting patients through the complex and deeply personal decisions inherent in localized prostate cancer management.<\/jats:p>","DOI":"10.1200\/edbk-26-515958","type":"journal-article","created":{"date-parts":[[2026,3,5]],"date-time":"2026-03-05T13:26:27Z","timestamp":1772717187000},"source":"Crossref","is-referenced-by-count":0,"title":["Balancing Cure and Quality of Life: Navigating Functional Outcomes in Localized Prostate Cancer"],"prefix":"10.1200","volume":"46","author":[{"given":"Abby L.","family":"Grier","sequence":"first","affiliation":[{"name":"School of Medicine, Case Western Reserve University School of Medicine, Cleveland, OH"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Erik","family":"Briers","sequence":"additional","affiliation":[{"name":"European Prostate Cancer Coalition (Europa Uomo), Antwerp, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Randie E.","family":"White","sequence":"additional","affiliation":[{"name":"Department of Urology, Vanderbilt University Medical Center, Nashville, TN"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel A.","family":"Barocas","sequence":"additional","affiliation":[{"name":"Department of Urology, Vanderbilt University Medical Center, Nashville, TN"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ronald C.","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, The University of Kansas Medical Center, Kansas City, KS"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gabriela","family":"Ilie","sequence":"additional","affiliation":[{"name":"Department of Urology, Faculty of Medicine, Dalhousie University, Halifax, NS, Canada"},{"name":"Department of Community Health and Epidemiology, Faculty of Medicine, Dalhousie University, Halifax, NS, Canada"},{"name":"Department of Radiation Oncology, Faculty of Medicine, Dalhousie University, Halifax, NS, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stacy","family":"Loeb","sequence":"additional","affiliation":[{"name":"Department of Urology and Population Health, NYU Langone Health and Manhattan Veterans Affairs, New York, NY"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8890-2951","authenticated-orcid":true,"given":"Pedro C.","family":"Barata","sequence":"additional","affiliation":[{"name":"Division of Solid Tumor Oncology, Department of Medicine, University Hospitals Cleveland Medical Center, Case Western Reserve University School of Medicine, Cleveland, OH"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"233","reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa074311"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.2217\/14796694.4.4.561"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1002\/pon.572"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2016.70.6317"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41391-024-00806-2"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.3747\/co.19.1287"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41391-025-01010-6"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2015.01.030"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1097\/JU.0000000000002757"},{"key":"e_1_3_3_11_2","volume-title":"NCCN Clinical Practice Guidelines in Oncology: Prostate Cancer. Version 5.2026","author":"National Comprehensive Cancer Network","year":"2026","unstructured":"National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology: Prostate Cancer. Version 5.2026. Plymouth Meeting, PA: National Comprehensive Cancer Network; 2026."},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.21037\/tau-22-732"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21857"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1200\/OP.21.00764"},{"key":"e_1_3_3_15_2","unstructured":"Veterans Health Library. U.S. Department of Veterans Affairs. February 3 2026. https:\/\/www.veteranshealthlibrary.va.gov\/RelatedItems\/RelatedDocuments.pg?d=&TypeId=142&ContentId=41713_va&Category=HS"},{"key":"e_1_3_3_16_2","unstructured":"Prostate Cancer UK. February 3 2026. https:\/\/prostatecanceruk.org\/"},{"key":"e_1_3_3_17_2","volume-title":"Patient Guides","author":"Urology Care Foundation","unstructured":"Urology Care Foundation: Patient Guides. February 3, 2026. https:\/\/www.urologyhealth.org\/educational-resources?topic_area=717%7C&product_format=466%7C&language=1122%7C"},{"key":"e_1_3_3_18_2","volume-title":"PDQ \u00ae Prostate Cancer Treatment\u2014Patient Version","author":"NCI","unstructured":"NCI: PDQ \u00ae Prostate Cancer Treatment\u2014Patient Version. February 3, 2026. https:\/\/www.cancer.gov\/types\/prostate\/patient\/prostate-treatment-pdq"},{"key":"e_1_3_3_19_2","volume-title":"Patient Guide to Localized Prostate Cancer","author":"Prostate Cancer Foundation","unstructured":"Prostate Cancer Foundation: Patient Guide to Localized Prostate Cancer. February 3, 2026. https:\/\/www.pcf.org\/patient-support\/patient-resources\/guides\/patient-guide-to-localized-prostate-cancer\/"},{"key":"e_1_3_3_20_2","volume-title":"Prostate Cancer: Early Stage","author":"NCCN Guidelines for Patients","unstructured":"NCCN Guidelines for Patients: Prostate Cancer: Early Stage. February 3, 2026. https:\/\/www.nccn.org"},{"key":"e_1_3_3_21_2","volume-title":"Survivorship Care for Healthy Living","author":"NCCN Guidelines for Patients","unstructured":"NCCN Guidelines for Patients: Survivorship Care for Healthy Living. February 3, 2026. https:\/\/www.nccn.org"},{"key":"e_1_3_3_22_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2023.26491"},{"key":"e_1_3_3_23_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2019.20675"},{"key":"e_1_3_3_24_2","doi-asserted-by":"publisher","DOI":"10.1111\/bju.15955"},{"key":"e_1_3_3_25_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12885-024-12850-1"},{"key":"e_1_3_3_26_2","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.24349"},{"key":"e_1_3_3_27_2","doi-asserted-by":"publisher","DOI":"10.1089\/end.2019.0361"},{"key":"e_1_3_3_28_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2011.05.001"},{"key":"e_1_3_3_29_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2020.05.041"},{"key":"e_1_3_3_30_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2018.11.035"},{"key":"e_1_3_3_31_2","doi-asserted-by":"publisher","DOI":"10.4103\/aja202481"},{"key":"e_1_3_3_32_2","doi-asserted-by":"publisher","DOI":"10.1111\/iju.15388"},{"key":"e_1_3_3_33_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2013.06.046"},{"key":"e_1_3_3_34_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2020.09.044"},{"key":"e_1_3_3_35_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2007.01.109"},{"key":"e_1_3_3_36_2","doi-asserted-by":"publisher","DOI":"10.1111\/iju.15654"},{"key":"e_1_3_3_37_2","doi-asserted-by":"publisher","DOI":"10.21037\/tau-23-337"},{"key":"e_1_3_3_38_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464-410X.2008.07515.x"},{"key":"e_1_3_3_39_2","doi-asserted-by":"publisher","DOI":"10.1038\/ijir.2008.33"},{"key":"e_1_3_3_40_2","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.35172"},{"key":"e_1_3_3_41_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1209978"},{"key":"e_1_3_3_42_2","doi-asserted-by":"publisher","DOI":"10.1056\/EVIDoa2300018"},{"key":"e_1_3_3_43_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2015.04.030"},{"key":"e_1_3_3_44_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoncol.2022.7592"},{"key":"e_1_3_3_45_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2024.07.2145"},{"key":"e_1_3_3_46_2","doi-asserted-by":"publisher","DOI":"10.3390\/curroncol28040246"},{"key":"e_1_3_3_47_2","first-page":"181","article-title":"Psychological morbidity associated with prostate cancer: Rates and predictors of depression in the RADICAL PC study","volume":"15","author":"Fervaha G","year":"2021","unstructured":"Fervaha G, Izard JP, Tripp DA, et al: Psychological morbidity associated with prostate cancer: Rates and predictors of depression in the RADICAL PC study. Can Urol Assoc J 15:181-186, 2021","journal-title":"Can Urol Assoc J"},{"key":"e_1_3_3_48_2","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/djad175"},{"key":"e_1_3_3_49_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoncol.2021.5160"},{"key":"e_1_3_3_50_2","doi-asserted-by":"publisher","DOI":"10.3390\/curroncol30090626"},{"key":"e_1_3_3_51_2","doi-asserted-by":"publisher","DOI":"10.3390\/cancers16132352"},{"key":"e_1_3_3_52_2","article-title":"Urinary and sexual function do not mediate psychological distress reduction in the PC-PEP randomized controlled trial: A secondary mediation analysis","author":"Salman B","year":"2026","unstructured":"Salman B, Smith NK, Ilie G, et al.: Urinary and sexual function do not mediate psychological distress reduction in the PC-PEP randomized controlled trial: A secondary mediation analysis. Can Urol Assoc J, 2026. [In review]","journal-title":"Can Urol Assoc J"},{"key":"e_1_3_3_53_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10943-023-01845-0"},{"key":"e_1_3_3_54_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12904-025-01768-5"},{"key":"e_1_3_3_55_2","doi-asserted-by":"publisher","DOI":"10.1089\/jpm.2020.0776"},{"key":"e_1_3_3_56_2","doi-asserted-by":"publisher","DOI":"10.1093\/oncolo\/oyab033"},{"key":"e_1_3_3_57_2","volume-title":"NCCN Clinical Practice Guidelines in Oncology: Distress Management, (Ed Version 1.2026)","author":"National Comprehensive Cancer Network","year":"2026","unstructured":"National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology: Distress Management, (Ed Version 1.2026). Plymouth Meeting, PA: National Comprehensive Cancer Network; 2026."},{"key":"e_1_3_3_58_2","doi-asserted-by":"publisher","DOI":"10.5489\/cuaj.9222"},{"key":"e_1_3_3_59_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41391-021-00350-3"},{"key":"e_1_3_3_60_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2015.10.047"},{"key":"e_1_3_3_61_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2007.15.4963"},{"key":"e_1_3_3_62_2","doi-asserted-by":"publisher","DOI":"10.1038\/nrurol.2016.46"},{"key":"e_1_3_3_63_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2024.9053"},{"key":"e_1_3_3_64_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2014.06.005"},{"key":"e_1_3_3_65_2","doi-asserted-by":"publisher","DOI":"10.1158\/1940-6207.CAPR-10-0229"},{"key":"e_1_3_3_66_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2014.60.2557"},{"key":"e_1_3_3_67_2","volume-title":"NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines\u00ae) Survivorship","author":"National Comprehensive Cancer Network","year":"2025","unstructured":"National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines\u00ae) Survivorship. Plymouth Meeting, PA: National Comprehensive Cancer Network; 2025."},{"key":"e_1_3_3_68_2","unstructured":"American Cancer Society: All About Cancer Prostate Cancer. February 3 2026. https:\/\/www.cancer.org\/cancer\/types\/prostate-cancer\/detection-diagnosis-staging.html"}],"container-title":["American Society of Clinical Oncology Educational Book"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/ascopubs.org\/doi\/pdfdirect\/10.1200\/EDBK-26-515958","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,6]],"date-time":"2026-03-06T14:03:35Z","timestamp":1772805815000},"score":1,"resource":{"primary":{"URL":"https:\/\/ascopubs.org\/doi\/10.1200\/EDBK-26-515958"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2]]},"references-count":67,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026,2]]}},"alternative-id":["10.1200\/EDBK-26-515958"],"URL":"https:\/\/doi.org\/10.1200\/edbk-26-515958","relation":{},"ISSN":["1548-8748","1548-8756"],"issn-type":[{"value":"1548-8748","type":"print"},{"value":"1548-8756","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2]]},"article-number":"e515958"}}