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Second Acta Oncologia Symposium on Prostate Cancer Controversies

An overview of the current and future status in the diagnosis and treatment of prostate cancer was presented during the Second Acta Oncologica symposium held on the Faeroe Islands. The specific areas covered included Etiology-BiologyPathology; Screening-Staging; Radiobiology; Curative Treatments of Localized Prostate Cancer; Endocrine Therapy, Chemotherapy, Bisphosphonates therapy and Gene and Immunotherapy. In addition to the presented invited papers a significant number of poster presentations were also given. This and a previous issue of ‘‘Acta Oncologica’’ include some of the information presented at this most interesting, informative, and in some sense provocative meeting. The current status of methods for detecting prostate cancer was discussed. The increase in the number of ultrasound guided core biopsies was noted. The reason for this increase is that the cancer detection rate is increased by up to 35% as compared to the detection rate with the standard number of biopsies. The prognosis of the individual cancer can be adequately predicted when pathological information concerning any extra-prostatic extension, margin status, tumor volume, number of positive cores, presence of vesicular invasion, and of most importance, Gleason Score is available. Unfortunately much of this data is only available on prostatectomy specimens. A major problem is determining the volume of the prostate. This is not easily done with present radiological techniques. However the development of newer approaches will be of great importance. A new target for evaluation of prostate cancer treatment and the significance and management of prostatic intraepithelial neoplasia (PIN) is under investigation. Estrogen receptor beta (ER-ß) signalling in the prostate is under intensive investigation. A pro-differentiative role for ER-b in the prostatic epithelium of mice was demonstrated. The results indicated that ER-ß might be a novel target for pharmacological intervention. Diet, life style, and the risk of prostate cancer was discussed by Alicja Wolk [1]. She noted that despite the fact that prostate cancer has become a major health problem worldwide, very little is known about the etiology. Dietary factors, dietary supplements and physical activity seem to have an impact in the causation and prevention of the disease. Greater risk is associated a high consumption of meats and dairy products. Some protection seems to be related to a diet including fatty fish and tomato products. Another factor related to an increased risk is high levels of circulating insulin like growth factor, IGF-1. Additionally it was noted that increased intake of vitamin E and selenium, and increased physical activity have a positive effect on decreasing the risk of prostate cancer [1]. Current controversies surrounding prostate cancer were discussed by Peter Albertsen [2]. He noted that the current primary curative treatments of prostate cancer, surgery and irradiation have few, if any, randomized trials that demonstrate their relative effectiveness, compared to ‘‘watchful waiting’’. In addition each treatment carries a significant incidence of treatment related disabilities. He noted the recent Swedish trial comparing surgery and watchful