Prostate cancer – Related resources

Cochrane reviews

• In patients with local prostate cancer and high risk features (extension to surgical margins, seminal vesicles or prostate capsule), adjuvant radiotherapy after prostatectomy appears to improve overall survival and reduce the rate of distant metastases, but these effects are only evident with longer follow up.
• Early androgen suppression in advanced prostatic cancer may provide a small improvement in overall survival. This outcome needs to be evaluated with the evidence suggesting higher costs and more frequent adverse effects with early therapy .
• Cryotherapy seems to offer a potential alternative to standard therapies for the primary treatment of localised prostate cancer, but the evidence is insufficient. Oral phosphodiesterase type 5 (PDE5) inhibitors appear to be effective for erectile dysfunction (ED) following radiotherapy of the prostate or radical prostatectomy .
• Intermittent androgen suppression (IAS) for prostatic cancer seems to result slightly reduced adverse events compared with continuous androgen suppression (CAS) although the evidence is insufficient. The relative effectiveness of IAS versus CAS for overall survival, prostate cancer-specific survival, or disease progression is not known .
• Five-alpha-reductase inhibitors (5ARI) appear to reduce prostate cancer risk but may increase the risk of high-grade disease in men who are undergoing regular screening for prostate cancer and who have a low baseline PSA value. The impact of 5ARI on rates of prostate cancer in men who are not being regularly screened is not clear .

Other evidence summaries

• 8% of men may be incontinent and nearly 60% may be impotent at 18 months or more following radical prostatectomy .

Literature

Clinical practice reviews

• Damber JE, Aus G. Prostate cancer. Lancet 2008 May 17;371(9625):1710-21.
• Walsh PC, DeWeese TL, Eisenberger MA. Clinical practice. Localized prostate cancer. N Engl J Med 2007 Dec 27;357(26):2696-705.

Systematic reviews and meta-analyses

• Chou R, Croswell JM, Dana T et al. Screening for Prostate Cancer: A Review of the Evidence for the U.S. Preventive Services Task Force. Ann Intern Med 2011 Oct 7 [Epub ahead of print]

Other literature

• van den Bergh RC, Vasarainen H, van der Poel HG et al. Short-term outcomes of the prospective multicentre 'Prostate Cancer Research International: Active Surveillance' study. BJU Int 2010;105(7):956-62.
• Andriole GL, Bostwick DG, Brawley OW, Gomella LG, Marberger M, Montorsi F, Pettaway CA, Tammela TL, Teloken C, Tindall DJ, Somerville MC, Wilson TH, Fowler IL, Rittmaster RS, REDUCE Study Group. Effect of dutasteride on the risk of prostate cancer. N Engl J Med 2010 Apr 1;362(13):1192-202.
• van den Bergh RC, Essink-Bot ML, Roobol MJ, Wolters T, Schröder FH, Bangma CH, Steyerberg EW. Anxiety and distress during active surveillance for early prostate cancer. Cancer 2009 Sep 1;115(17):3868-78.
• Albertsen PC, Hanley JA, Fine J. 20-year outcomes following conservative management of clinically localized prostate cancer. JAMA 2005 May 4;293(17):2095-101.
• Steineck G, Helgesen F, Adolfsson J, Dickman PW, Johansson JE, Norlén BJ, Holmberg L, Scandinavian Prostatic Cancer Group Study Number 4. Quality of life after radical prostatectomy or watchful waiting. N Engl J Med 2002 Sep 12;347(11):790-6.