Prostate Cancer Disease Summary

Overview

Prostate cancer is the second most common cancer in men and one of the most common cancers in men more than 50 years of age as stated in the Introduction section.

Prostate cancer is the fourth most common cancer in the world. Incidence and prevalence of this cancer worldwide and regionally can be found in the Epidemiology section.

Prostate cancer arises from the epithelium, normally in the peripheral glandular portion of the prostate. The pathogenesis of prostate cancer is androgen-dependent, and these processes are discussed in the Pathophysiology section.

The Risk Factors section discusses the different factors that can contribute to the development of prostate cancer.

History and Physical Examination

The Clinical Presentation section enumerates the early manifestations of prostate cancer, among of which are polyuria, nocturia and hematuria.

As stated in the Physical Examination section, digital rectal examination is essential in assessing patients suspected to have prostate cancer.   

The Screening section enumerates the recommendations in screening patients suspected to have prostate cancer.

Diagnosis

Prostate biopsy is the most common method used in diagnosing prostatic carcinoma. Other tests to assess patients suspected of having prostate cancer are enumerated and discussed in the Laboratory Tests and Ancillaries and Imaging sections.

The Diagnosis or Diagnostic Criteria section enumerates the key examinations recommended in diagnosing prostate cancer.

The Differential Diagnosis section enumerates the diseases that may mimic prostate cancer, and these should be ruled out.

Management

The Evaluation section mentions the Tumor, Nodes, and Metastasis (TNM) system of staging prostate cancer. This section also states that staging should be based on the PSA level, tumor grade, and positive prostate biopsies. Risk stratification and other assessment methods should also be done.

Treatment strategies for androgen deprivation therapy, castration-resistant prostate cancer (CRPC), adenocarcinoma-type metastatic CRPC are discussed in the Principles of Therapy section.

The Pharmacological Therapy section includes the discussion of drug options used in the treatment of patients with prostate cancer. This includes androgen deprivation therapies, LHRH analogs, androgen pathway targeting agents, and other secondary hormone therapy. This section also contains information on non-hormonal systemic therapies, chemotherapy, targeted therapy, immunotherapy, and palliative therapies.

Recommendations for patients who will undergo observation and active surveillance are enumerated in the Nonpharmacological section.

Surgery is an option for the management of prostate cancer, and the techniques are enumerated and discussed in the Surgery section.

Radiation therapy may be given depending on the patient’s risk status. The different types of radiation therapy are analyzed in the Radiation Therapy section.

Disease recurrence should be monitored using different examinations. Tests and assessments to be done in surveillance of patients with prostate cancer as well as salvage treatments are in the Monitoring section. Referral to palliative care specialists should also be considered.