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The Management of Prostate Cancer

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Radiation Therapy for Genitourinary Malignancies

Part of the book series: Practical Guides in Radiation Oncology ((PGRO))

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Abstract

The prostate gland is part of the male reproductive system and resides in the male pelvis. The prostate is an androgen-driven organ and can transform to develop prostate adenocarcinoma. Prostate cancer is the most common cancer in men. There is tremendous diversity in the natural history of prostate cancer. The majority of men with prostate cancer will die from other causes. For this reason, more indolent tumors can safely be monitored without immediate radical therapy, termed active surveillance. However, given the immense heterogeneity and high prevalence of this disease, prostate cancer remains the second leading cause of cancer death. This heterogeneity in outcomes is predicted clinically from a patient’s prostate-specific antigen, stage, and grade. Newer imaging and molecular gene expression tests aim to further improve risk stratification. Patients who have more aggressive prostate cancer require definitive treatment, which most often consists of a backbone of radiotherapy or surgery and may require multi-modality therapy in the form of radiotherapy with androgen-deprivation therapy (ADT) or surgery with radiotherapy ± ADT. For patients with metastatic disease, the backbone of systemic therapy is ADT, and more recently is often combined with next-generation androgen receptor-signaling inhibitors or chemotherapy. Furthermore, radiotherapy to the primary is now a standard of care component of treatment for patients with limited metastatic disease, and a growing body of evidence supports the potential role for metastasis-directed radiotherapy. However, across all disease states, patients commonly live for multiple years, if not decades, after their diagnosis. Thus, an increased focus has been placed on optimizing patient health-related quality of life and survivorship care.

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Conflicts of Interest

Daniel E Spratt: Advisory board for Blue Earth and Janssen.

All others have no COI.

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Authors and Affiliations

  1. Department of Radiation Oncology, University of Michigan, Ann Arbor, MI, USA

    Robert T. Dess, William C. Jackson & Daniel E. Spratt

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  1. Robert T. Dess
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  2. William C. Jackson
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  3. Daniel E. Spratt
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Correspondence to Daniel E. Spratt .

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Editors and Affiliations

  1. Department of Radiation Oncology, Loyola University Chicago, Maywood, IL, USA

    Abhishek A. Solanki

  2. Department of Radiation Oncology, University of Kansas Medical Center, Kansas City, KS, USA

    Ronald C. Chen

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Dess, R.T., Jackson, W.C., Spratt, D.E. (2021). The Management of Prostate Cancer. In: Solanki, A.A., Chen, R.C. (eds) Radiation Therapy for Genitourinary Malignancies . Practical Guides in Radiation Oncology. Springer, Cham. https://doi.org/10.1007/978-3-030-65137-4_1

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  • DOI: https://doi.org/10.1007/978-3-030-65137-4_1

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