ABSTRACT
Lung and breast cancer are the most frequently diagnosed tumors in the United States. After lung cancer, prostate cancer is the second leading cause of death by cancer in men. Since the introduction of the prostate specific antigen (PSA) blood test, screening for prostate cancer has diagnosed over 180,00 new cases per year. Death from prostate cancer is on the decline, with 32,000 cases expected yearly. Over the past decade, mortality from prostate cancer has declined 1-2% per year. The impact of screening for prostate cancer also has resulted in migration of the initial diagnostic staging from advanced disease 20 years ago to the present where the majority of cases are diagnosed at a lower and localized stages. This is fortunate since metastatic prostate cancer is generally not curable by conventional therapy and over time will lead to death. Interventions with anti-androgens, luteinizing hor mone releasing hormone (LHRH) or orchiectomy, however, may slow the progres sion of these androgen-dependent tumors and increase longevity. Over the past decade, treatment of localized prostate cancer by refined surgical and radiation therapy techniques has resulted in excellent survival rates at 5 and 10 years. In the following three chapters, we will discuss the treatment of localized disease by surgery and radiation techniques, and finally, the treatment of advanced disease.
