Progress In Clinical Research Of Prostate Cancer Screening And Treatment

Prostate cancer is one of the most common malignant tumors which threaten the health of men. In Europe and the United States, the incidence of prostate cancer ranked the second in all male tumors. With the development of society and economy, the incidence of prostate cancer has increased annually in China. PSA screening can find out a large number of early prostate cancers in advance for 5-10 years. And the 5 year survival rate of those early prostate cancer patients was 100%. But prostate cancer is such a highly heterogeneous tumor that PSA screening has led to overdiagnosis and overtreatment severely, which may increase the burden on patients and the whole society. Given the purpose of treatment is to prolong the patient’s lifespan and improve the quality of life in the future, it is worth discussing whether the screening and treatment of prostate cancer can achieve this purpose.In order to guide the clinical practice and to make clear the direction of research in future, the author searched the clinic studies according to the key words, i.e. “prostate cancer, screening, treatment, clinical trials’ ’ to retrieve data of clinical trials according to prostate cancer screening and treatment.The results show that prostate cancer screening did not significantly improve the all cause overall survival rate of the screening population and was of limited value in reducing prostate cancer specific mortality. PIVOT study showed that PSA screening had no significant benefit in all cause overall mortality and prostate cancer special mortality according to radical prostatectomy. Men with PSA level greater than 10ng/ml or high-risk disease may be benefit with radical prostatectomy. The SPCG-4 data showed a substantial reduction in prostate cancer special mortality after radical prostatectomy only among men younger than 65 years. Most studies suggested that primary androgen deprivation therapy does not improve survival of patients. Conservative managements, such as active surveillance, may be better for low risk prostate cancer. Some new drugs for advanced prostate cancer were developed in recent years, and improved overall survival of these patients was achieved in some degree.This review encourages us to develop new tumor markers to stratify low and high risk prostate cancer and detect prostate cancer patients who actually benefit from early treatments in order to reduce the possibility of overdignosis and overtrement. Urologists should formulate individualized treatment programs and precise treatments to bring benefit to patients indeed.