DIAGNOSIS AND TREATMENT OF PROSTATE-CANCER

In the United States, prostate cancer is the most common solid tumor m alignancy in men and second to lung cancer as the leading cause of can cer deaths in this group. Even though prostate cancer is responsible f or 40,000 deaths per year, screening programs are a matter of controve rsy because scientific evidence is lacking that early detection decrea ses morbidity and mortality. Furthermore, treatment decisions are diff icult to make because of the generally indolent nature of prostate can cer and because it tends to occur in older men who often have multiple competing medical illnesses. Depending on the specific situation, rad ical prostatectomy, radiotherapy or watchful waiting (observation) wil l be the most appropriate manage ment option. In general, localized ca ncer is best treated with surgical removal of the prostate gland or ra diotherapy. Hormone deprivation therapy is the primary method of contr olling metastatic prostate cancer. At present, chemotherapy cannot cur e disseminated prostate cancer. Watchful waiting is a reasonable manag ement alternative for prostate cancer in an older patient or a patient with other serious illnesses.