New principles in the treatment of prostate cancer--the oncologist's view

From the oncologist's perspective an interesting development has occurred during the last 10 years regarding the treatment of prostate cancer. In patients with localized prostate cancer the combination of neo-adjuvant hormonal therapy and radiotherapy has been associated with improved survival compared to radiotherapy alone. As prostate cancer patients treated with low doses of external beam radiotherapy, e.g. 70 Gy, have a risk of tumour-like cells remaining in the prostate, there has been renewed interest in the use of dose-escalation radiotherapy for treating localized prostate cancer using various techniques. The reported results indicate benefits in terms of metastasis-free survival and also suggest improved overall survival. New chemotherapy drugs, e.g. mitoxantrone and taxans, are presently being tested in hormone-refractory prostate cancer and hopefully will improve outcomes. Fascinating results have been reported with the combination of radioisotopes and chemotherapy. These results will hopefully add new options for the treatment of prostate cancer. The present overview deals with some of these aspects.