Mary Beth Nierengarten

A recently published population-based study reinforces prior evidence from retrospective studies of the increased survival benefit of partial nephrectomy over radical nephrectomy, and suggests a cancer-specific survival benefit for nephron-sparing approaches as well.

Chicago-Although open radical prostatectomy remains the gold standard of treatment for clinically localized prostate cancer, laparoscopic prostatectomy and, more recently, robot-assisted laparoscopic prostatectomy are rapidly increasing in popularity as alternatives to traditional open prostatectomy techniques.

Chicago-Although chemotherapy reigns supreme as the most effective systemic therapy to treat advanced prostate cancer, it is being contested with the rapid emergence and development of novel agents that are showing great promise in targeting pathways of cancer without causing damage to normal cells. However, it doesn't appear that chemotherapy will be relegated to the history books any time soon. Even if targeted therapies prove to be all they promise they may be, chemotherapy may still be essential.

Chicago-Whether chemotherapy may benefit men with locally advanced prostate cancer is still not known, but it is hoped that clinical trials currently under way may provide some evidence on the potential role of adjuvant or neoadjuvant chemotherapy in this setting.

Chicago-For men diagnosed with early prostate cancer or localized disease, the roles of the urologist, surgical oncologist, and radiation oncologist have been fairly well defined. The role of medical oncologists in managing patients in the early stages of the disease is less clear.

Chicago-With the evolving definition of advanced prostate cancer that now includes a number of clinical states not previously defined, treatment has also evolved into a multimodal approach. This mandates close cooperation among urologists and medical and radiation oncologists to ensure optimal patient care, according to leading oncologists.

Chicago-One of the most difficult issues in the management of prostate cancer is identifying which men with indolent disease are at increased risk of progressing to more advanced disease. Reliance on traditional clinical prognostic factors, including PSA, has provided some guidance on treatment, but all too often, men with indolent disease are over-treated based on an incomplete knowledge of disease risk.