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Prostate Cancer - part 5

Ung thư tuyến tiền liệt cục bộ tồn tại, và làm thế nào để chúng tôi chẩn đoán nó? Các chương trình chẩn đoán và sàng lọc sớm ung thư tuyến tiền liệt (PC) đã dẫn đến một tỷ lệ lớn hơn của bệnh nhân với bệnh thấp giai đoạn chẩn đoán | Does Localized Prostate Cancer Exist Bernard Lobel Recent Results in Cancer Research Vol. 175 Springer-Verlag Berlin Heidelberg 2007 Abstract Does localized prostate cancer exist and how do we diagnose it Early diagnosis and screening programs for prostate cancer PC have led to a greater proportion of patients with a low-stage disease at diagnosis. More men are treated with curative intent by radical prostatectomy RP external beam radiotherapy or brachytherapy. However a substantial percentage of patients still experience a prostate-specific antigen PSA relapse within 5 years. Biochemical recurrence is observed in approximately 40 of patients who undergo RP with 95 of those relapses in the first 5 years. To avoid the risk of recurrence the recent tendency has been to detect PC at a lower PSA level than the level widely accepted 4.0 ng ml . But the risk of overdiagnosis and overtreatment is a real problem in the PSA era. Discussion around the wide discrepancy between the high prevalence of histological changes recognizable as cancer and the much lower prevalence of clinical disease is prominent. The recent experience from studies on watchful waiting and the results of randomized trials between surgery and active surveillance have clearly demonstrated that many localized PC are overtreated. New screening and management strategies are required to target aggressive disease at an early stage while avoiding overdiagnosis and overtreatment. Introduction Early diagnosis and screening programs for prostate cancer PC have led to a greater proportion of patients with a low-stage disease at diagnosis. More men are treated with curative intent by radical prostatectomy external beam radiotherapy or brachytherapy. However a substantial percentage of patients still experience a prostate-specific antigen PSA relapse within 5 years 3 . Biochemical recurrence is observed in approximately 40 of patients who undergo radical prastaectony RP with 95 of those relapses in the first 5 years