Implant Radiation Therapy or Surgery in Treating Patients With Prostate Cancer

DISEASE CHARACTERISTICS

Meeting 1 of the following criteria:

* Prostate cancer or suspected prostate cancer confined to the prostate (Decision-Aid Randomization) Clinical stage T1/T2, Due for prostate biopsy or prostate biopsy performed in the last 6 weeks, PSA \< 15 ng/mL
* Histologically confirmed prostate cancer (Treatment Randomization): Clinical stage T1/T2, Re-biopsy after a period of active surveillance is at the discretion of the treating investigator, Must meet 1 of the following risk criteria (PSA test \< 3 months prior to treatment intervention), Low risk: Gleason score ≤ 6 (no tertiary grade 4 or 5) with a PSA of \< 10 ng/mL, intermediate-risk: Gleason score 3 + 4 (no tertiary grade 5) with a PSA \> 10 ng/mL but ≤ 15 ng/mL, Transrectal ultrasound prostate volume ≤ 50 cc

PATIENT CHARACTERISTICS:

* WHO performance status 0-1
* Life expectancy \> 10 years (Decision-Aid Randomization)
* Satisfactory results from biochemical and hematological profiles that, in the opinion of the investigator, does not preclude patient from the trial
* No unacceptable risk for radical prostatectomy or prostate brachytherapy
* INR \< 1.5
* No severe lower urinary tract symptoms
* No significant obstructive urinary symptoms (i.e., peak urine flow rate \< 10 mL per second, and/or post micturition bladder volume \> 100 mL)
* No other clinical or medical condition that, in the opinion of the investigator, precludes patient from taking part in the trial
* No other active malignancy likely to interfere with subsequent protocol treatment and follow-up

PRIOR CONCURRENT THERAPY:

* No prior pelvic radiotherapy
* No prior abdominoperineal (AP) rectal excision
* No prior standard transurethral resection of prostate
* No prior or concurrent neoadjuvant or adjuvant hormonal treatment, (e.g., LHRH agonists, or anti-androgens or estrogens)
* At least 5 days since prior aspirin or clopidogrel
* No concurrent warfarin