Vol. 43 (4): 584-587, July – August, 2017
doi: 10.1590/S1677-5538.IBJU.2017.04.03
DIFFERENCE OF OPINION
Ariel A. Schulman 1, Thomas J. Polascik 1
1 Division of Urology, Duke University Medical Center, Durham, NC, USA
Keywords: Prostatic Neoplasms; Patients; Epidemiology
We are in the midst of a major shift in the diagnosis and management of localized prostate cancer. The prevailing approach of the 1980’s and 1990’s focused on widespread population-based prostate specific antigen (PSA) testing and curative-intent treatment for any detected cancer. The philosophical approach in the most recent decade is now defined by risk-adapted PSA screening, and integration of novel imaging techniques and biomarkers to increase the detection of clinically significant cancer. Concomitantly, we are witnessing the expanding utilization of active surveillance and partial ablation trategies to avoid overtreatment. We believe that continued development in each of these areas will continue to decrease the number of patients with localized disease treated with traditional whole gland surgery or radiation in the future…
