FUTURE STUDIES IN LOCALIZED PROSTATE-CANCER - WHAT SHOULD WE THINK - WHAT CAN WE DO

The proper approach to the diagnosis and treatment of localized prosta te cancer is controversial and emotionally charged. The controversy fr om a urological viewpoint is reviewed, and the future clinical studies that must be done to prevent the disease, improve therapy and validat e aggressive early diagnostic strategies are described briefly. It is proposed that the greatest need for the future is a change in the atti tudes of the participants. This attitudinal change must occur in sever al areas: 1) a new determination to conduct the appropriate clinical t rials, 2) different ways of conceptualizing the disease that better ex plain the current screening data, paradox between cancer incidence and lethality, and conflict between aggressive (United States) and conser vative (Scandinavian) styles of management, and 3) renewed tolerance, understanding and humility toward the different points of view.