genitourinary disorders
Prostate Cancer
Key Points
Prostate cancer develops very commonly with aging but is not always clinically important. Symptoms develop only after the cancer has enlarged enough to be more difficult to cure. Complications due to bone metastases are common and consequential. Diagnose prostate cancer by transrectal or transperineal ultrasound-guided needle biopsy. Discuss advantages and disadvantages of screening in men>age 50 with life expectancy>10 or 15 years. For localized prostate cancer, consider local, curative treatment (eg, prostatectomy, radiation therapy) and active surveillance. For cancer that has spread beyond the prostate, consider systemic treatments (eg, various hormonal therapies,sipuleucel-T, taxane chemotherapy). For bone metastases, consider radium-233 and osteoclast inhibitors. 