Adenocarcinoma of the prostate is the most commonly diagnosed malignancy
in men in the United States. It is estimated that, in 2005, 232 000 new
cases will be diagnosed and 30 350 men will die from this disease.1 Even though prostate-specific antigen (PSA) screening
has not been conclusively demonstrated to reduce mortality from prostate cancer,
this practice has been widely adopted in the United States. As a result, more
patients are being diagnosed at a younger age and with disease localized to
the prostate.1,2 For these patients,
radical prostatectomy (RP) and radiation therapy (RT) remain the mainstays
of curative therapy.3 Nevertheless, prostate
cancer remains primarily a disease of older men, many of whom have other serious
coexisting illnesses from which they may be far more likely to die. Thus,
it remains a major challenge for the clinician to identify which patients
need aggressive treatment and which do not.
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