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• Highlights
• Introduction
• Prognosis
• Risk Factors
• Symptoms
• Conditions with Similar Symptoms
• Screening and Diagnosis
• Tests to Determine Severity of Cancer
• Staging and Grading
• Treatment Options by Staging and Grading
• Treatment for Localized Prostate Cancer
• Surgery
• Radiation Treatments
• Options if Treatments Fail
• Other Treatments
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Prostate cancer

Description

An in-depth report on the causes, diagnosis, treatment, and prevention of prostate cancer.

Highlights

Watchful Waiting Versus Treatment

The debate continues over whether or not men diagnosed with low-grade local prostate cancer should delay treatment:

• A 2005 New England Journal of Medicine study found that some men who underwent radical prostatectomy surgery had a better chance for survival than men who chose watchful waiting.
• A 2006 Prostate Cancer Symposium study found that men who had radiation or surgery had a 30% lower risk of death than those who chose watchful waiting.
• A 2005 Journal of the American Medical Association study recommended watchful waiting over surgery or radiation. Researchers found a low risk of death up to 20 years after diagnosis for men with low-grade cancer who had observation or hormonal drug therapy.

Prostate Specific Antigen (PSA) Velocity

How quickly PSA levels rise (“PSA velocity”) is as important as the levels themselves, according to several recent studies. The studies indicate that:

• Men with early-stage cancer who have slow-rising PSA levels are more likely to survive than men with fast-rising levels.
• PSA velocity may help doctors decide which patients should receive hormonal drugs along with radiation treatment.

Prostate Cancer Screening

Screening tests for prostate cancer may not reduce men’s risk of death, according to a 2006 study in the Archives of Internal Medicine . The small study of 1,000 men found no differences in survival between men who had prostate specific antigen tests or digital rectal exams, and men who were not screened. Doctors should inform men of the uncertainty of prostate cancer tests so that patients understand the relative risks and benefits of screening.

Genetics

In 2005, scientists achieved a major breakthrough by identifying a set of genes involved in prostate cancer. The scientists think that some types of prostate cancer occur when these genes merge. This research may lead to better methods of diagnosis and treatment.

• Review Date: 7/9/2006
• Reviewed By: Harvey Simon, M.D., Editor-in-Chief, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital.

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