Screening and early hormonal treatment of prostate cancer are accumulating strong evidence and support.
BACKGROUND
I review the data published during the last 5 years on the effects of early treatment of prostate cancer on survival.


METHODS
Data from prospective and randomized studies as well as from population-based studies are presented.


RESULTS
Two studies (European Organization for Research and Treatment of Cancer and Radiation Therapy Oncology Group) in stage T3 disease have shown that long-term (3 years or indefinite, respectively) androgen blockade prolongs life in patients receiving androgen blockade in addition to radiotherapy compared to radiotherapy alone. In the UK Medical Research Council study, androgen blockade at diagnosis of locally advanced or asymptomatic patients decreased cancer-specific death by 21% compared to delayed treatment. A 69% decrease in prostate cancer death was observed in the Quebec Randomized Prostate Cancer Screening Study. Population-based studies in Sweden and Denmark have shown that 62% and 63%, respectively, of patients diagnosed with localized prostate cancer will die from the disease if not treated immediately. Decreases in prostate cancer death rate of 6.3-23% have been found between 1991-1997 in the US and Canada, respectively.


CONCLUSIONS
Treatment of localized disease has been shown in all the available randomized studies to cause a marked decrease in prostate cancer death. Simple use of the available screening procedures and treatments for localized prostate cancer could cause a dramatic decrease in prostate cancer death.
Labrie
F
F
Oncology and Molecular Endocrinology Research Center, Department of Medicine, CHUL Research Center, Centre Hospitalier Universitaire de Québec and Laval University, Quebec City, Quebec, Canada. fernand.labrie@crchul.ulaval.ca
D000726:Androgen Antagonists / Q000627:therapeutic use*; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008403:Mass Screening; D009367:Neoplasm Staging; D011446:Prospective Studies; D011471:Prostatic Neoplasms / Q000175:diagnosis / Q000188:drug therapy* / Q000401:mortality / Q000517:prevention & control; D016032:Randomized Controlled Trials as Topic; D012307:Risk Factors; D016019:Survival Analysis
D000726:Androgen Antagonists; D018931:Antineoplastic Agents, Hormonal