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Does Localized Prostate Cancer Exist?

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Book cover Prostate Cancer

Part of the book series: Recent Results in Cancer Research ((RECENTCANCER,volume 175))

Abstract

Does localized prostate cancer exist, and how do we diagnose it? Early diagnosis and screening programs for prostate cancer (PC) have led to a greater proportion of patients with a low-stage disease at diagnosis. More men are treated with curative intent by radical prostatectomy (RP), external beam radiotherapy, or brachytherapy. However, a substantial percentage of patients still experience a prostate-specific antigen (PSA) relapse within 5 years. Biochemical recurrence is observed in approximately 40% of patients who undergo RP, with 95% of those relapses in the first 5 years. To avoid the risk of recurrence, the recent tendency has been to detect PC at a lower PSA level than the level widely accepted (≥4.0 ng/ml). But the risk of overdiagnosis and overtreatment is a real problem in the PSA era. Discussion around the wide discrepancy between the high prevalence of histological changes recognizable as cancer and the much lower prevalence of clinical disease is prominent. The recent experience from studies on watchful waiting and the results of randomized trials between surgery and active surveillance have clearly demonstrated that many localized PC are overtreated. New screening and management strategies are required to target aggressive disease at an early stage while avoiding overdiagnosis and overtreatment.

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Author information

Authors and Affiliations

  1. Hôital Pontchaillou, Rue Henri Le Guilloux, 35033, Rennes, France

    Bernard Lobel (Head of the Department of Urology)

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  1. Bernard Lobel
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Editors and Affiliations

  1. The Chaim Sheba Medical Center, Tel-Hashomer, Ramat-Gan, 52621, Israel

    Jacob Ramon MD

  2. Lange Gasthuisstraat 35-37, 2000, Antwerp, Belgium

    Louis J. Denis MD, FACS (Director Oncology Centre Antwerp Secretary Europa Uomo) (Director Oncology Centre Antwerp Secretary Europa Uomo)

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© 2007 Springer-Verlag Berlin Heidelberg

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Lobel, B. (2007). Does Localized Prostate Cancer Exist?. In: Ramon, J., Denis, L.J. (eds) Prostate Cancer. Recent Results in Cancer Research, vol 175. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-540-40901-4_7

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  • DOI: https://doi.org/10.1007/978-3-540-40901-4_7

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-40897-0

  • Online ISBN: 978-3-540-40901-4

  • eBook Packages: MedicineMedicine (R0)

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