Prostate cancer. Localized tumor. Treatment risks vs. benefits? 4
Let’s discuss prostate cancer treatment. Clinically localized prostate cancer presents a diagnostic and therapeutic challenge. Dr. Anton Titov, MD. Do we have to resect the whole prostate gland? Do we have to do aggressive therapy of localized prostate cancer? Can we simply observe a patient with local prostate cancer? Dr. Anton Titov, MD. How to monitor patients with localized prostate cancer? You have led several clinical trials in a localized form of prostate cancer. What did clinical trials show? Dr. Anton Titov, MD. What is the best therapy for the localized prostate cancer? Dr. Jack Cuzick, PhD. Prostate cancer is an even bigger challenge that early breast cancer. Because excessive treatment is sometimes unnecessary in breast cancer. But over-treatment in breast cancer usually does not carry significant morbidity compared with the treatment of prostate cancer. A radical prostatectomy is usually associated with urinary incontinence. It can last for up to a year. Prostate cancer therapy often results in sexual impotence. So the decision to do a radical treatment of prostate cancer is more difficult. Because the side effects and morbidity are greater in therapy of prostate cancer. It is also clear that screening for prostate cancer does lead to the detection of many early prostate cancers. This is very common in the United States. Dr. Jack Cuzick, PhD. There is an opinion even to call some of these early prostate cancers “pre-cancer”. Although all prostate cancers are formally “cancer”. Because histologically they satisfy all the requirements of cancer. All prostate cancer are invasive. Carcinoma of prostate penetrates through basement membrane. But many of prostate cancers will not progress actively. But this is a diagnostic problem in prostate cancer. We can do something as simple as a needle biopsy of prostate gland. Dr. Anton Titov, MD. Can we decide which patients can be safely observed and followed? What patients with prostate cancer have high enough risk to need radical prostate cancer treatment immediately.
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