Prostate Cancer

Abstract

The prostate is a walnut‐sized gland located between the bladder and external urinary sphincter through which the urethra passes. The primary function of the prostate is to produce a slightly alkaline fluid that protects spermatozoa from the acidic environment found within the vaginal tract; hence, it is important in reproduction. Adenocarcinoma of the prostate is the second most commonly diagnosed cancer in men worldwide, with approximately 99% of cases occurring in men over the age of 50. Improvements in screening techniques and aggressive treatment have led to markedly improved survival rates over the past two decades. Treatment‐related side effects and ‘overtreatment’ of prostate cancer, however, have significantly impacted prostate cancer survivors and thus ignited a significant amount of controversy regarding prostate cancer screening. Key Concepts Prostate cancer is among the most frequent causes of cancer in men. Hereditary prostate cancer has been associated with inherited mutations in many different genes including BRCA1 , BRCA2 , ATM and CHEK2 . Prostate‐specific antigen can be used to detect early‐stage prostate cancer and monitor response to treatment. Treatment decisions for localised prostate cancer are complex and must take into account patient age, life expectancy, overall medical condition and patient preferences. Treatment of localised prostate cancer mainly consists of active surveillance, radical prostatectomy or radiation therapy with androgen deprivation therapy. Additional treatment modalities are being actively studied including cryosurgery, brachytherapy and high intensity focused ultrasound.