Controversies in the Treatment of Prostate Cancer

One of the real challenges in managing prostate cancer appears to be differentiating patients with clinically relevant cancers from those patients who may not become systematic despite being left untreated. These 15 articles, based on those presented at a symposium on special aspects of radiotherapy held in September 2006, describe surgical, radio-oncological and especially systemic interventions as options. Those indicated for localized and locally advanced prostate cancer include active surveillance, radical prostatectomy, radiotherapy and hormonal therapies, including using hormone therapy as a immediate intervention, while those on cases with involvement of the lymph nodes include using radiotherapy for a potential cure. Treatments addressed for biochemical recurrence include radiotherapy after surgery and treatment for recurrence after radiotherapy and those addressing hormone-refractory metastatic cancers include secondary hormonal manipulation, chemotherapy, palliative radiotherapy. Particularly interesting is a report of a clinical trial comparing weekly Taxotere plus Prednisone with a Prednisone-only regimen.