Prostate cancer

Abstract

Prostate cancer presents one of the most controversial challenges to clinicians today. Where controversies may exist as to how best to treat many diseases, the controversies in prostate cancer start with the question, Should we even try to diagnose this disease before it becomes clinically evident? When the disease is found, the next question is whether the disease should be treated and whether the cure is worse than the disease. The next set of controversies revolve around how to most effectively treat the tumor. If a decision is made to proceed with radiation, the final controversies revolve around radiation fields and techniques. Each of these decision points can provoke heated discussions among recognized authorities in the field. This chapter attempts to discuss the controversies with the data supporting each point. It is likely that partisans of any argument will find support for their position, but it is also likely that a disinterested observer will see logic in each position. Before reviewing the controversies, it is necessary to develop a common foundation for the discussion. © 2006 Springer Science+Business Media, Inc.