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