Screening and hormonal therapy of localized prostate cancer shows major benefits on survival

Five recent randomized studies demonstrate that treatment of localized pros tate cancer saves lives. Since prostate cancer grows insidiously without si gns or symptoms until it reaches the bones - when cure has become an except ion-screening is essential to diagnose the disease at an earlier stage when cure is possible in the majority of patients. At 7 years' median follow-up with continuous hormonal therapy, cancer-specific death was observed in le ss than 5% of patients with treatment started at the stage of clinically lo calized disease, compared to 70% to 90% when treatment is started in patien ts with bone metastases. With appropriate screening, 99% of prostate cancer s can be diagnosed at the localized stage with no sign of bone metastases. Starting androgen blockade at time of diagnosis of localized disease can ac hieve long-term control of the disease in dose to 100% of patients and even cure the disease in the majority of them, as evidenced by maintenance of u ndetectable PSA in 85% of patients after cessation of long-term combined ho rmonal therapy. The available data indicate that the use of regular PSA scr eening and immediate treatment can markedly reduce mortality rates among pr ostate cancer patients. Next steps toward improving the quality of life for prostate cancer patients including more tolerable treatments and preventio n steps are underway.