Prostate cancer is the second most common cancer diagnosed in men in Australia and the third most common cause of cancer death. It is estimated that 18,110 new cases of prostate cancer will be diagnosed in Australia in 2021. One in 6 men will be diagnosed with prostate cancer by the age of 85. It is more common in older men, with over 63% of cases diagnosed in men over 65 years of age. Early (localised) prostate cancer refers to cancer cells that have grown but do not appear to have spread beyond the prostate.
There are two stages of advanced prostate cancer:
The five year survival rate for prostate cancer is 95%. Cancer Council
UpToDate
Screening
Treatment
e-Books
Journals
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Screening
Prostate-specific Antigen testing as part of a risk-adapted early detection strategy for prostate cancer: European Association of Urology Position and Recommendations for 2021
The EAU has developed a risk-adapted early prostate cancer detection strategy for well-informed men based on PSA testing, risk calculators, and multiparametric magnetic resonance imaging, which can differentiate significant from insignificant prostate cancer. This approach largely avoids the overdiagnosis/overtreatment of men unlikely to experience disease-related symptoms during their lifetime and facilitates an early diagnosis of men with significant cancer to receive active treatment. It also reduces advanced-stage diagnosis, thereby potentially reducing prostate cancer–specific mortality and improving quality of life. Education is required among urologists, general practitioners, radiologists, policy makers, and healthy men, including endorsement by the European Commission to adapt the European Council’s screening recommendations in its 2022 plan and requests to individual countries for its incorporation into national cancer plans. European urology August 5 2021
MRI-targeted or standard biopsy in prostate cancer screening
MRI with targeted and standard biopsy in men with MRI results suggestive of prostate cancer was noninferior to standard biopsy for detecting clinically significant prostate cancer in a population-based screening-by-invitation trial and resulted in less detection of clinically insignificant cancer. NEJM 2 September 2022
Evaluating two decision aids for Australian men supporting informed decisions about prostate cancer screening: A randomised controlled trial
Both DAs were useful and acceptable to men regardless of education level and both supported informed decision making. The long version resulted in higher knowledge, and a higher proportion of men able to make an informed choice, but the differences were small. Long DAs may be useful for men whose informational needs are not satisfied by a short DA. Plos one 15 January 2020
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Treatment
Future directions in systemic treatment of metastatic hormone-sensitive prostate cancer
The landscape of advanced prostate cancer treatment has evolved tremendously in past decades. The treatment paradigm has shifted from androgen deprivation therapy (ADT) alone to doublet combinations comprising ADT with docetaxel or an androgen receptor inhibitor, and now triplet therapy involving all 3 classes of agents. Robust clinical data has demonstrated survival benefits with this strategy of upfront treatment intensification. Subgroup analysis has alluded to the importance of tailoring treatment according to metastatic disease burden. However, defining the volume of disease is becoming increasingly controversial due to the advent of next generation molecular imaging. Several trials testing established agents in the castrate-resistant setting are now underway in metastatic hormone sensitive prostate cancer patients. As the treatment milieu is enriched earlier in the disease trajectory, future studies should elucidate biomarkers to further define specific patient populations who will benefit most from treatment intensification and/or de-escalation, with what agents and for what duration. World journal of urology 27 August 2022
Darolutamide and survival in metastatic, hormone-sensitive prostate cancer
In this trial involving patients with metastatic, hormone-sensitive prostate cancer, overall survival was significantly longer with the combination of darolutamide, androgen-deprivation therapy, and docetaxel than with placebo plus androgen-deprivation therapy and docetaxel, and the addition of darolutamide led to improvement in key secondary end points. The frequency of adverse events was similar in the two groups. NEJM 24 March 2022
Prostate-only versus whole-pelvic radiation therapy in high-risk and very high-risk prostate cancer (POP-RT): Outcomes from phase III randomized controlled trial
Prophylactic pelvic irradiation for high-risk, locally advanced prostate cancer improved biochemical failure-free survival (BFFS) and disease-free survival (DFS) as compared with prostate-only radiotherapy (PORT), but overall survival (OS) did not appear to differ. Journal of clinical oncology 26 January 2021
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This is a sample of the e-books the library subscribes to – you will need your library login
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This is a sample of the journals the library subscribes to – you will need your library login
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