Evaluation of Four Treatment Modalities in Prostate Cancer With Low or "Early Intermediate" Risk

Inclusion Criteria:

* Newly diagnosed, biopsy proven adenocarcinoma of the prostate (ultrasound guided biopsy by standardized protocol)
* Men aged 18-75 years
* Recruitment within 3 months after histological confirmation
* Localized prostata cancer \<= cT2a, NX or N0 M0
* PSA \<= 10 ng / ml
* Gleason score \<= 7a (3 +4)
* ECOG performance status 0 or 1
* \<= 30% positive biopsy cores with largest contiguous tumor length \<= 5 mm
* IPSS score \< 18
* Urine flow (Qmax):\> 15 ml / s

Exclusion Criteria:

* Unifocal Gleason 6 cancer \<1mm
* History of treatment for BPH e.g. TURP, HIFU or cryotherapy
* History of radiation therapy to the pelvis
* Life expectancy \<10 years
* ASA \>= 4
* Post-void residual urine \> 50 ml
* Prostate volume on transrectal ultrasound \> 60 cm3
* large median prostate lobe visualized on transrectal ultrasound
* chronic intestinal inflammatory disease covering the rectum
* Other active malignancy within the past 5 years (except for superficial basal cell carcinoma or non muscle infiltrating bladder carcinoma)
* contraindications for prostatectomy, radiation therapy or Active Surveillance
* Patients refusing written informed consent