Treatment of locally advanced prostate cancer with radiation therapy

External beam radiation has been the most common curative treatment for the patient with Stage C prostate cancer, with ten-year survivals of 38-40 percent and ten-year free-from-recurrence rates of 28 percent and 30 percent. A number of problems are apparent, including the need to confirm positive imaging studies by biopsy, the need to avoid the apparent adverse effects of transurethral resection of the prostate (TURP) in a subset of Stage C patients, the need to complete ongoing prospective trials of adjuvant androgen deprivation, and the need to complete trials of neutron therapy and implants designed to improve local control. Patients with Stage C cancer should be encouraged by their physicians to enter prospective trials addressing these pertinent questions.