[Prostatic cancer].

Abstract

The incidence of prostatic cancer has been increasing and will probably increase more in Japan in the future, although it may not be probable that the incidence become high as in the western countries. Carcinoma of the prostate gland is one of cancers in which main treatment modality is hormonal manipulation. It is evident through epidemiological study that the development of prostatic cancer is associated with environmental factors such as dietary or sexual life styles which may influence on the hormonal milieu. In animal models aging and androgens are indispensable factors when inducing prostatic cancer. Thus the mechanism of hormone dependency in prostatic cancer should be elucidated to consolidate the basis of its hormonal therapy. It is shown in in vivo or in vitro experiments that the hormonal action is mediated by several growth factors. However, this must be investigated when androgens or growth factors play their roles during the process of carcinogenesis. While the main therapy of prostatic cancer is hormonal it is generally accepted that a radical means to treat prostatic cancer is solely total excision of the prostate gland when cancer is confined to the prostate. Hormone therapy is conservative principally, but is only available means now for treating patients with advanced prostatic cancer. In order to obtain more effective hormonal manipulation, the mechanism of hormone dependency must be understood. We need more effective antiandrogenic agents with lesser adverse effects. The final goal in the treatment of prostatic cancer is in its eradication. Therefore, it is urgently necessary to establish multidisciplinary treatment which includes surgery, hormonal manipulation, chemotherapy, radiation and immunotherapy for the eradication of advanced prostatic cancer.