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The evolving biology and treatment of prostate cancer
Russel S. Taichman, … , Rohit Mehra, Kenneth J. Pienta
Russel S. Taichman, … , Rohit Mehra, Kenneth J. Pienta
Published September 4, 2007
Citation Information: J Clin Invest. 2007;117(9):2351-2361. https://doi.org/10.1172/JCI31791.
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Science in Medicine

The evolving biology and treatment of prostate cancer

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Abstract

Since the effectiveness of androgen deprivation for treatment of advanced prostate cancer was first demonstrated, prevention strategies and medical therapies for prostate cancer have been based on understanding the biologic underpinnings of the disease. Prostate cancer treatment is one of the best examples of a systematic therapeutic approach to target not only the cancer cells themselves, but the microenvironment in which they are proliferating. As the population ages and prostate cancer prevalence increases, challenges remain in the diagnosis of clinically relevant prostate cancer as well as the management of the metastatic and androgen-independent metastatic disease states.

Authors

Russel S. Taichman, Robert D. Loberg, Rohit Mehra, Kenneth J. Pienta

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Figure 1

Evolving screening guidelines for prostate cancer detection: NCCN early detection screening guideline.

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Evolving screening guidelines for prostate cancer detection: NCCN early ...
Physicians should initiate a discussion of the risks and benefits of early prostate cancer detection and offer baseline screening with DRE and PSA beginning at age 40. PSA values are shown in ng/ml. Men with PSA less than 0.6 ng/ml at age 40 should repeat screening at age 45; if PSA is less than 0.6 ng/ml at age 45, annual screening should be considered at age 50. If initial PSA at age 40 is 0.6 ng/ml or more, or if the patient has a family history of prostate cancer (+FH) or is African American, annual screening with DRE and PSA is recommended. If subsequent PSA is less than 0.6 ng/ml, the patient can repeat screening at age 45; all others should continue with annual screening. In the annual screening group, men with PSA 2.6–4.0 ng/ml, or whose PSA velocity (PSAV) exceeds 0.35 ng/ml/yr, should be considered for biopsy. Biopsy is highly recommended for any individual with PSA greater than 4.0 ng/ml and for men with positive DRE at any point in the screening process. Note that PSA velocity measurements (shown in ng/ml/yr) should be made on at least 3 consecutive specimens drawn over a period of at least 18–24 months.
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