Following institutional review board approval for this study and after informed consent from patients is obtained, men referred to our institution for treatment of clinically localized prostate cancer will be interviewed at baseline following diagnosis but prior to making a treatment decision, by a research study coordinator whom we will train in utility assessment. At that initial interview, the patient's utilities will be assessed, in a private consultation room, for each important post-treatment health state that he potentially may enter. The states we would assess include living with untreated prostate cancer, impotence, urinary dysfunction, bowel dysfunction, rising PSA following definitive local therapy, and metastatic prostate cancer. We will also record characteristics of the patient's disease (pretreatment serum PSA, clinical stage, biopsy Gleason grade), demographics (age, race, level of education, employment, marital status) and comorbidity. Patient-reported urinary, bowel, and sexual function/bother will be assessed at baseline using a short form version of a 48-item validated HRQOL instrument for localized prostate cancer. All patient information will be entered into a secure, HIPAA-compliant database accessible only to the principal investigator, research study coordinator(s), data manager, and biostatistician. All patient identifying information will be removed prior to data analysis and will not be included in any publication or presentation that results from this study. For all patients, the quality-adjusted disease-free survival for each treatment modality will be calculated using the decision analysis model. For the decision analysis arm of the trial, this information will be conveyed to the patient and the physician prior to treatment decision. These patients will also receive standard treatment counseling. For the control arm, both patients and physicians will be unaware of the decision analysis recommendation and the patients will receive standard treatment counseling alone. After the patient has made a treatment decision he will be given a short questionnaire to assess decisional conflict. If after one month no treatment decision information is available, a letter and form requesting treatment information along with the decisional conflict questionnaire will be sent to patients. At 6, 12, and 24 months following the treatment decision, the patient will be sent a brief validated questionnaire which will measure his regret of treatment choice, treatment satisfaction, decisional conflict and current health state utility using validated instruments. A short form version of a 48-item validated questionnaire will also assess his HRQOL for urinary, bowel and sexual function/bother domains at these time intervals. Approximately two weeks after receiving each follow-up questionnaire and/or letter, a member of the study group will contact the patient by telephone if we have not received the completed questionnaire. S/he will inquire about any difficulties with the questionnaire and will remind the patient about sending it back.