Urology

Article Abstract:

The diagnosis and treatment of prostate cancer continues to be controversial. The number of diagnosed cases rose 40% between 1990 and 1992, but this is probably due to new technology that detects tumors earlier. Measuring serum prostate-specific antigen (PSA) is often used to screen men for prostate cancer, but it is not clear if widespread PSA screening would be cost-effective. Measuring the proportion of total PSA that is not bound may distinguish benign prostatic enlargement from prostate cancer. One research study found that men with low-grade cancer had mortality rates similar to that of men without prostate cancer. However, men with moderate- to high-grade cancer had higher mortality rates. The National Cancer Institute has begun a study to see if aggressive surgical treatment of high-grade prostate cancer can lower mortality rates. Surgery appears to be more effective in treating benign prostatic enlargement than watchful waiting.

Measurement, Prostate-specific antigen, Prostate specific antigen, Prostate, Prostatic hyperplasia

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Long-term survival among men with conservatively treated localized prostate cancer

Article Abstract:

Men aged 65 to 75 years with low-grade prostate cancer appear to survive as long as men of the same age group in the general population. Researchers identified 451 patient records of men aged 65 to 75 through the Connecticut Tumor Registry. The patients, diagnosed with prostate cancer between 1971 to 1976, were classified as having low-grade, moderate-grade or high-grade tumors based on a tumor biopsy. Their survival rates were compared with population life expectancy charts for Connecticut men. After a 15-year follow-up, none of the men with low-grade prostate cancer had died within seven years and only 9% died within 15 years. Twenty-eight percent of the men with moderate-grade disease died within 15 years of diagnosis. Fifty-one percent of the men who had high-grade prostate cancer died within 15 years of diagnosis.

Prognosis

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Urology

Article Abstract:

Research on benign prostate hyerplasia reveals that drugs called alpha-blockers may be effective in reducing symptoms. Herbal medicines and microwave therapy have also been tried, but there is no long-term evidence of their effectiveness. The use of radioactive implants has been tried in the treatment of prostate cancer. Men with localized disease may also benefit from prostate removal. Screening for prostate cancer is still controversial. The drug alprostadil has been tested in men with erectile dysfunction and surgery has been beneficial in the treatment of incontinence.

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