title: Management of locally advanced prostate cancer.
abstract: The staging and treatment of prostate cancer are complex, particularly in patients with clinical disease that has advanced locally beyond the confines of the gland. Management choices are made more difficult by a paucity of quality randomized and controlled studies. Staging has traditionally relied on digital rectal examination, which is now being augmented by improved noninvasive radiologic studies. Radiation is the most common form of treatment today, and newer techniques are being examined and compared to external-beam therapy. Surgical intervention as monotherapy has failed to show a survival advantage. Current approaches treatment appear to be evolving toward combination therapies, potentially incorporating hormonal manipulation. Patients with locally advanced disease should be encouraged to enter prospective clinical trials.
authors.affiliation: Division of Urology, Georgetown University Hospital, Washington, DC, USA.
authors.forename: R M
authors.initials: RM
authors.lastname: Mordkin
authors.forename: W S
authors.initials: WS
authors.lastname: Hayes
authors.forename: M R
authors.initials: MR
authors.lastname: Kuettel
authors.forename: J H
authors.initials: JH
authors.lastname: Lynch
mesh_terms: D003131:Combined Modality Therapy; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009367:Neoplasm Staging / Q000379:methods; D010166:Palliative Care; D010173:Palpation; D017430:Prostate-Specific Antigen / Q000097:blood; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000175:diagnosis / Q000628:therapy*; D011878:Radiotherapy / Q000379:methods; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed
chemical_list: D017430:Prostate-Specific Antigen