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The future management of prostate cancer?

In improving the management of prostate cancer, cryotherapy, interstitial laser ablation and high intensity focused ultrasound may prove to be preferable to radical prostatectomy. For patients with advanced, metastatic or recurrent disease, the mainstay of therapy is likely to remain combined androgen blockage, that is the use of a luteinising hormone-releasing hormone analogue and antiandrogen combination. Other possible new therapeutic advances include the use of growth factor inhibitors such as suramin in hormone escaped prostate cancer and the use of gene therapy. In conclusion, the best hopes for managing prostate cancer lie in earlier detection of the disease, and there is a need for improved diagnostic indicators. It is also important, as a general principle, to increase the efficacy and reduce the morbidity of therapies. However, increased survival is not the only issue as improvements in quality of life are fundamental in patients with prostate cancer.