What do we expect from treating prostate cancer?
Article published in Urologia Polska 2007/60/4.

authors

Peter Whelan

St James’s University Hospital, Urology Department, Leeds, United Kingdom

keywords

prostate, prostate cancer, treatment

summary

In 1980 expectations for the treatment of prostate cancer were modest. Half the patients presented with metastases and required palliative treatment but because the age of presentation was several years older than the average life expectancy, palliation

was accepted for the same reason that half the patients who did not have metastases at presentation frequently died with, rather than of, the cancer”. With the increasing use of PSA, only a diagnosis has been accomplished although this is likely to be mostly due to lead time bias. Less than 10% of patients now present with metastases and the outlook of any patient with prostate cancer is that they will live for many years. In the overuse of hormones in treating PSA rises, a new disease of hormone resistant prostate cancer without metastases was evolved, and effective palliative therapy is threatening to be taken away from patients when they progress and develop bone disease. The new consensus suggestions of defining active surveillance with intervention in only those cases that appear to be progressing, the use of new therapies to try and deal with biochemical failure alone and the saving of hormonal treatment for progression objectively, to either lymph nodes or bones may evolve into the new treatment paradigm for prostate cancer.

references

correspondence