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Feature Article

Prostate cancer: what’s new?

Richard Savdie, Phillip D Stricker AO

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Abstract

Although there is still no recommended prevention policy for prostate cancer, advances are being made in its earlier detection and treatment.

Key Points

  • The overall philosophy in prostate cancer screening is to detect significant cancers in those who could benefit from their diagnosis.
  • The increased use of active surveillance for patients with low-risk prostate cancer is reducing overtreatment.
  • New tests now available are the Prostate Health Index (PHI) and the urinary PCA3 test. The PHI has better sensitivity but not specificity than the PSA test; the PCA3 test offers little over the PSA test.
  • Improved imaging with multiparametric MRI shows promise in appropriate detection of prostate cancer as well as localising and ascertaining the nature of tumours.
  • Improved surgical and radiotherapeutic options plus focal therapies under investigation are likely to change the way prostate cancer will be managed in the next five to 10 years.

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