For men who choose surgical removal, the latest cutting edge options offer them a few advantages.
Many doctors offer men robot assisted laparoscopic prostatectomies because they reduce the risk for incontinence and impotence. There's limited blood loss and a quick recovery.
Sandy Schondelmayer runs his own successful barbecue business and he's also living with prostate cancer.
"I don't want to take the risk of the side effects from surgery," said Schondelmayer.
A new study looks at the effectiveness of these new advanced treatments.
"Over the past decade, there has been an introduction of new technologies with the potential to mitigate those side effects," said Dr. Brent K. Hollenbeck from the University of Michigan.
Those new technologies include robotic surgery. Magnification allows the surgeon to better visualize the prostate and more precisely remove the cancer while potentially minimizing side effects. Another newer technology is known as intensity modulated radiation therapy or IMRT.
"The idea is you can give higher doses to the prostate and the cancer without necessarily affecting the surrounding tissues as much," said Hollenbeck.
Hollenbeck and co-authors studied Medicare beneficiaries 66 and older diagnosed with prostate cancer. In a report provided by the Journal of the American Medical Association, researchers focused on low risk patients, like Schondelmayer, and those who had a high chance of dying from non-cancer related causes.
They found the use of robotic surgery and IMRT rose significantly among these men whom most experts regard as inappropriate candidates. And it's expensive.
"It has the potential to sort of amplify the financial implications for the U.S. healthcare system," said Hollenbeck.
Experts say long-term studies that look at whether these treatments actually reduce side effects have been mixed.