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