Early diagnosis and treatment of prostate cancer
Prostate cancer represents a significant challenge to society and to physicians. It is a remarkably prevalent tumor, perhaps the most common cancer in the world in its histologic manifestation. In its clinically apparent form, its behavior is notably heterogeneous. Some patients live with a prostate cancer that remains stable for decades without treatment. In others, the cancer grows aggressively, responds poorly to therapy, and causes morbidity and even mortality within a few years. The median loss of life expectancy for men diagnosed with prostate cancer has been estimated at 9 years. Important progress has been made in the past 2 decades in the treatment of prostate cancer. Further advances will be required for a more accurate characterization of the primary tumor in each individual patient to more appropriately tailored treatment - whether conservative or aggressive, operation or radiation - more accurately to the nature of the individual cancer. Imaging modalities, in particular, must be improved if we are to have better, noninvasive ways to identify the presence of a cancer and to define its volume, location, and extent. Substantial progress against this disease will require major breakthroughs in our understanding of the etiology and biology of prostate cancer, the development of effective chemopreventive agents, more accurate ways to assess the biologic potential of the tumor, and more effective systemic agents to treat metastatic cancer.