Facing progressive localized prostatic cancer

Patients diagnosed with locally progressive prostate cancer can be divided into three groups according to the stage of their disease. The first group includes patients with locally progressive cancer presenting initially as either T3 or T4; the second group involves individuals treated curatively who then develop local progression in the pelvis; the third group includes patients who present with metastatic disease and who develop recurrence of locally advancing disease in the pelvis despite undergoing hormonal therapy. This article reviews the treatment options currently available for patients in these three groups. The factors involved in deciding which is the most appropriate therapy are discussed, and the effectiveness of each treatment and the complications associated with it are presented.