Expectant management: an option for localized prostate cancer

Area of Science:

• Oncology
• Urology

Background:

• Localized prostate cancer exhibits significant heterogeneity in disease progression.
• While histological cancer is common in older men, the risk of clinically significant disease and mortality is considerably lower.

Purpose of the Study:

• To review the evolution of expectant management strategies for localized prostate cancer.
• To address the challenge of overtreatment for potentially insignificant prostate cancer.

Main Methods:

• This is a review article, discussing the historical development and current considerations of expectant management.
• Literature review on prostate cancer natural history and management strategies.

Main Results:

• The natural history of prostate cancer varies widely, with a substantial proportion of detected cancers not progressing to clinically significant disease.
• Lifetime risk of developing significant disease is 18%, while the risk of dying from prostate cancer is less than 4%.

Conclusions:

• Expectant management is a viable approach for select men with localized prostate cancer.
• Careful patient selection is crucial to differentiate between indolent and aggressive disease, thereby optimizing treatment decisions.