Recent articles, reviews, reports and research relating to determining what treatment option for prostate cancer is appropriate

PSA testing in prostate cancer: Early treatment Vs observation. Article by Anna Azvolinsky - CancerNetwork Oncology 21 March 2014. This is an interesting article reporting views of two notable USA doctors - Timothy Wilt and Ballentine Carter. They discuss the the contrasting strategies of early intervention on the one hand versus watchful waiting / active surveillance on the other. The opinions expressed may be of interest to anyone who is contemplating treatment options after a diagnosis of prostate cancer. Read the web article here or here:

Individualized approach to management of patients with prostate cancer. In a Medscape Urology article dated 15 October 2013, Steven Joniau et al discuss the possible use of "individualized, risk-adapted approaches" to management of patients with prostate cancer. In the abstract for the article it is stated: "Prostate cancer (PCa) is a heterogeneous disease with a wide spectrum of aggressiveness. Evidence-based guidelines are invaluable but cannot be expected to be extensive enough to provide detailed guidance on the management of all patients. As such, the use of individualized, risk-adapted approaches to the management of PCa is indispensable. However, wide variation in treatment approaches observed for patients in practice suggests that there is an unmet need to improve the individualized approach towards patient care. A holistic approach that encompasses guidelines and evidence-based medicine could be used to guide individualized care for patients with PCa, from first contact through to final outcomes. As a result of an international expert meeting, this paper proposes this approach and highlights some of the factors that can be considered when aiming to identify patients' profiles; individualize treatment; and improve communication between patients and the healthcare teams." The article can be read here:

Issues in the treatment of prostate cancer. In the September 2013 edition of the Translational Andrology and Urology; 2013;2(3) is an informative review by J L Silberstein et al relating to issues concerning treatment of prostate cancer. In the abstract of the article the authors make these observations: "Appropriate risk stratification for men with newly diagnosed prostate cancer is an appropriate first step for all patients. Once risk-stratified, for those with low-risk of death, it is increasingly recognized that overtreatment creates an unnecessary burden for many patients. This is particularly evident when put in the context of competing comorbidities in an elderly population. For those with advanced or high-risk localized disease, under-treatment remains too common. For those with a high-risk of recurrence or failure following primary treatment, adjuvant or salvage therapies are an option, but how and when to best deploy these treatments are controversial." The full article can be read here: or here:

Treatment options for older prostate cancer patients. The conclusions reached by a research team led by Dr Timothy Daskivich at the UCLA are summarised In a May 20 2013 press release by Kim Irwin: "Older prostate cancer patients with other underlying health conditions should think twice before committing to surgery or radiation therapy for their cancer, according to a multi-center study led by researchers from the UCLA Department of Urology…The study reports 14-year survival outcomes for (3,183) men diagnosed with prostate cancer between 1994 and 1995. The results suggest that older patients with low- or intermediate-risk prostate cancer who have at least three underlying health problems, or comorbidities, are much more likely to die of something other than their cancer…'For men with low-to-intermediate–risk disease, prostate cancer is an indolent disease that doesn't pose a major risk to survival,' said the study's first author, Dr. Timothy Daskivich, a UCLA Robert Wood Johnson fellow. 'The take-home point from this study is that older men with multiple underlying health problems should carefully consider whether they should treat these tumors aggressively, because that treatment comes with a price.' " The full press release is here: and Anna Azvolinsky's 28 May 2013 article in CancerNetwork provides a few more details: