Advances in prostate cancer.
PURPOSE OF REVIEW: The purpose of this review is to highlight the most important developments in the diagnosis, prevention, and management of prostate cancer reported in the past year that have been published in the medical literature. RECENT FINDINGS: Recent research has yielded important insights into the effects of lowering the serum prostate-specific antigen threshold for prostate biopsy on the incidence of prostate cancer and suggests that a cutoff value of 2.5 ng/mL would double the rate of diagnosis of the disease in young men. Other developments demonstrate that oral finasteride reduces the incidence of the disease but increases the proportion of high-grade tumors. The incidence of mutations of the androgen receptor gene has been shown to be lower than was previously thought. New randomized data suggest that for patients with high-risk localized prostate cancer treated with radiation, 4 months of androgen deprivation in combination with whole pelvis radiotherapy confers a clinical benefit. The clinical benefits associated with chemotherapy and supportive care therapies such as the bone targeting bisphosphonates continue to be refined. SUMMARY: The data reported in the past year have widespread implications for all clinicians involved in the management of prostate cancer, ranging from primary care physicians who screen for and diagnose the disease to those who manage localized as well as systemic disease. Several of the year's findings will result in significant changes in the manner in which the disease is treated.