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Current clinical challenges in prostate cancer.

Jonathan L Silberstein1, Sumanta Kumar Pal1, Brian Lewis1

  • 1Department of Urology (JLS, OS) and Department of Medicine (BL, OS) Tulane University School of Medicine, New Orleans, LA and Department of Medical Oncology & Experimental Therapeutics (SKP) City of Hope Comprehensive Cancer Center, Los Angeles, CA, USA.

Translational Andrology and Urology
|January 28, 2016
PubMed
Summary

Prostate cancer treatment faces challenges from overtreatment of low-risk cases and under-treatment of high-risk disease. Recent advances in metastatic castrate-resistant prostate cancer (mCRPC) offer new options but introduce complex treatment decisions.

Keywords:
Prostate neoplasmsactive surveillance (AS)castrate-resistancechemotherapyhormone therapysurvival

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Area of Science:

  • Urology
  • Oncology
  • Clinical Medicine

Background:

  • Prostate cancer is a leading cause of cancer death in US men, with significant treatment costs.
  • Current prostate cancer management involves numerous controversies and challenges for clinicians and patients.
  • Risk stratification is crucial for appropriate prostate cancer treatment decisions.

Purpose of the Study:

  • To review current clinical challenges in prostate cancer management.
  • To discuss issues related to overtreatment and under-treatment across different disease stages.
  • To highlight recent therapeutic advancements and associated challenges in metastatic castrate-resistant prostate cancer (mCRPC).

Main Methods:

  • Review of critical recent studies and clinical paradigms in prostate cancer treatment.
  • Discussion of controversies in risk stratification, overtreatment, and under-treatment.
  • Analysis of new FDA-approved agents for mCRPC and their clinical implications.

Main Results:

  • Low-risk prostate cancer patients may face overtreatment burdens, especially with comorbidities.
  • High-risk localized and advanced prostate cancer patients are often under-treated.
  • Recent approvals of five novel agents for mCRPC present new challenges in timing, sequencing, and combinations.

Conclusions:

  • Addressing overtreatment in low-risk and under-treatment in high-risk prostate cancer is essential.
  • New therapeutic agents for mCRPC offer hope but require careful clinical navigation.
  • Ongoing research and clinical discussion are vital to overcome persistent challenges in prostate cancer care.