Progress in detection and treatment of prostate cancer

The purpose of this review is to highlight the most important developments in the diagnosis, prevention, and management of prostate cancer reported in the past year that have been published in the medical literature.

Recent research has shown that clinically meaningful prostate cancer can develop in patients with a PSA value <4 ng/dL and has suggested that 'watchful waiting' approaches may not be appropriate for young patients or those with a life expectancy of greater than 15 years. The contribution of obesity to high-grade disease and a higher rate of relapse has also been described. There is now randomized data suggesting that adjuvant hormonal therapy for as little as six month's time confers a survival benefit for those receiving radiation therapy. Secondary hormonal manipulation with ketoconazole is now supported by randomized phase III data. Most importantly, this year the results of two randomized phase III clinical trials of chemotherapy in hormone refractory prostate cancer have shown that survival can be increased by 20% with the use of docetaxel.

Recent data reported in the past year have significant implications for those involved in the management of prostate cancer. The results of the chemotherapy trials have resulted in new standards of care for this disease.