Prostate cancer: screening, diagnosis, and management

Area of Science:

• Oncology
• Urology

Background:

• Prostate cancer is a significant health concern with increasing incidence and detection rates.
• Current management strategies involve diagnosis, screening, staging, treatment, and psychosocial considerations.

Purpose of the Study:

• To offer physicians a comprehensive review of prostate cancer management.
• To cover all stages of prostate cancer, from diagnosis to future research.

Main Methods:

• A MEDLINE search was conducted for articles on prostate cancer diagnosis, staging, screening, and treatment.
• Emphasis was placed on large cooperative trials, consensus conferences, and organ site workshops.
• Data synthesis focused on randomized trials with long-term follow-up for localized disease and survival outcomes for metastatic disease.

Main Results:

• Information on localized prostate cancer relies on nonrandomized studies with heterogeneous groups and varied outcome measures.
• Data for metastatic prostate cancer management are more quantitative, including side effects and survival from randomized, multi-institutional studies.
• Significant controversies persist regarding screening, staging evaluation, and optimal treatment for prostate cancer.

Conclusions:

• Despite advances, considerable debate exists on prostate cancer screening advisability and effectiveness.
• Optimal staging evaluation and treatment choices for prostate cancer present inherent ambiguities for physicians.
• Physicians must carefully consider available evidence and patient-specific factors when making prostate cancer management decisions.