Prostate cancer--more information and more questions.

摘要

Prostate specific antigen (PSA) is the workhorse of tumor markers in modern oncology and to our knowledge no other marker has been more used, interrogated, cross-examined or manipulated. The increasing use of lower PSA thresholds for prostate biopsy especially in younger men led to more than 230,000 new cases of prostate cancer (CaP) last year with approximately 27,000 attributable deaths from the disease. Nearly half of currently diagnosed prostate cancers can be classified as low risk, ie low grade and stage, organ confined with a prolonged and still poorly understood natural history.2 However, the majority of these tumors are actively treated with surgery, some form of radiation or hormonal ablation.3 These data suggest that more men are living and dying with the effects of CaP treatments than are dying of the disease. The appropriate time to initiate PSA screening and the best threshold for biopsy remain unknown, and are a matter of much debate.