[Prostatic cancer: what is new?]

Recent advances, particularly in the fields of biology and nuclear medicine, have improved our understanding of carcinoma of the prostate and, thereby, have contributed to a more precise application of the different therapeutic approaches currently available. Although cytology and "immunological" assay of prostate phosphatases have not replaced rectal examinations in the diagnosis of this condition, it is now possible to assess its stage and "aggressivity" very accurately. Staging the disease demands exhaustive investigation, especially when the cancer is small; although blood-born metastases can be rapidly demonstrated, it is much more difficult to affirm the localised, purely intracapsular form of epithelioma; lymphography and surgical "picking" of lymph nodes should be considered in some cases. The stage and evolution of the cancer, and the general condition of the patient may indicate therapeutic abstention, palliative treatment (hormone therapy) and, all too rarely, an attempt at radical surgical care. There are a number of therapeutic choices of sometimes surprising, sometimes disappointing efficacy, especially in cases "escaping" oestrogen control, heralded by a rise in phosphatase levels.