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 upAdjuvant Radiotherapy Following Radical Prostatectomy for Prostate Cancer with High Risk Characteristics.
• 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 Early Versus Deferred Androgen Suppression in the Treatment of Advanced Prostatic Cancer.
• Cryotherapy seems to offer a potential alternative to standard therapies for the primary treatment of localised prostate cancer, but the evidence is insufficient. Cryotherapy for Localised Prostate Cancer
• 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 Intermittent Versus Continuous Androgen Suppression for Prostatic Cancer.
• 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 Five-Alpha-Reductase Inhibitors for Prostate Cancer Prevention.

Other evidence summaries

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

Literature

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] [PubMed]