Current controversies in the management of localized prostate cancer.
As longevity has improved and mortality from cardiovascular and other diseases has declined, the risk of death from prostate cancer has increased steadily.
Though slow growing, prostate cancer is not a benign disease.
Nearly 10% of men in Western countries will be diagnosed with prostate cancer sometime during their life and 3% will die of the disease.
The prospects for long-term control of prostate cancer diminish rapidly once the cancer has spread beyond the immediate periprostatic tissue.
The 5-year survival rate for men with metastases is less than 30% and almost all will eventually die of their disease.
A simple blood test, prostate-specific antigen (PSA), is available.
This test, when used in conjunction with ultrasound-guided systematic needle biopsy of the prostate, will detect potentially lethal prostate cancers earlier than digital rectal examination (DRE).
Definitive treatment, especially with radical prostatectomy, can eradicate the tumor in 90% of patients if the cancer is still confined to the prostate pathologically, regardless of the tumor grade.
Randomized, prospective clinical trials are now underway to demonstrate conclusively whether screening or early definitive therapy will substantially reduce the mortality rate from this disease.
Until the results of these trials are available, we recommend that healthy men over age 50, who have a life expectancy of 10 years or longer, have an annual PSA and DRE to detect prostate cancer while it is still curable.
Mots-clés Pascal : Epithélioma, Prostate, TNM système, Prostatectomie, Radiothérapie, Antiandrogène, Antigène associé tumeur, Marqueur tumoral, Traitement, Dépistage, Survie 5 ans, Homme, Mâle, Etats Unis, Amérique du Nord, Amérique, Exploration, Anticancéreux, Tumeur maligne, Appareil génital mâle pathologie, Appareil urinaire pathologie, Prostate pathologie, Chirurgie, Chimiothérapie, Antigène PSA
Mots-clés Pascal anglais : Carcinoma, Prostate, TNM-System, Prostatectomy, Radiotherapy, Antiandrogen, Tumor associated antigen, Tumoral marker, Treatment, Medical screening, Five year survival, Human, Male, United States, North America, America, Exploration, Antineoplastic agent, Malignant tumor, Male genital diseases, Urinary system disease, Prostate disease, Surgery, Chemotherapy, Prostate specific antigen
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 95-0500040
Code Inist : 002B14D02. Création : 01/03/1996.