Introduction: prostate cancer

Article Outline

• Copyright

PROSTATE CANCER as a disease is ever-changing in its evolution. While diagnosed and treated earlier, nevertheless, the disease can relapse biochemically and ultimately in bone and viscera, necessitating treatment. Appropriate interventions allow patients to live longer with continued excellent quality of life. What we are now learning is that the standard treatment algorithms of the past that mandated that a specific treatment be used for a particular clinical “state” of the disease no longer apply; in fact, hormonal therapy, once the “gold standard” of initial treatment for primary treatment failure, can be used anytime during the disease’s transition through the metastatic state and can be applied intermittently, in concert with chemotherapy, or with biologic agents. Chemotherapy, once used only in the salvage setting, has made its foray into the neoadjuvant arena prior to either surgery or radiation. It is clear as we enter the new millennium that treatment paradigms are changing, now being based on risk stratification, as well as biologic behaviors indigenous to the patient’s tumor. This issue of Seminars in Oncology reflects the exciting aspects of current thinking as to how prostate cancer is now viewed as a disease entity and the implementation of novel paradigms in its treatment.

This issue is dedicated to two prostate cancer survivors: my father and brother. “May they live long and prosper.”