ABSTRACT
Prostate cancer is the commonest cancer among men with up to 1 in 7 men developing the disease in their lifetime. The development of prostate cancer is not strongly associated with modifiable risk factors, which limits primary prevention. This chapter explains that there is much debate on the value of systematic prostate-specific antigen (PSA) screening among asymptomatic men because of ‘false positives’ and possible unnecessary treatment and possibly harmful consequences. Most guidelines do not recommend universal screening by PSA, but suggest individualizing the discussion about it in men aged 50–69 years. Prostate cancer does not usually cause symptoms until the cancer has grown large enough to cause urinary symptoms. Diagnosis is based on ultrasound, MRI, biopsies and exams to assess cancer stage and spread. Prostate cancer is a highly curable disease if diagnosed timely but treatment can affect a person's quality of life. The chapter outlines treatment options, including surgery, radiotherapy, hormone therapy, immunotherapy and palliative care where needed, but can be limited to active surveillance in some patients as prostate cancer is generally slow growing. As for all cancers, there is a need for networks of care, with centres of excellence that can provide high-quality multidisciplinary care, as well as ensuring that treatment is included in universal health care.
