Prostate cancer (PCA) is the most frequent tumour type in males and the third most frequent cause of male death due to malignancy. More than one million men in the European Union suffer from prostate cancer and more than 200.000 new cases were diagnosed in 2004 with an estimated 68.200 deaths (1). Therefore prostate cancer is a major concern of public health because of its high incidence, its high prevalence and its associated morbidity. Early prostate cancer usually does not cause any symptoms. However, as the tumour grows, it may spread from the prostate to surrounding areas. Change in urination, including increased frequency, hesitancy or dribbling of urine may be experienced. Prostate cancer can spread from the prostate to nearby lymph nodes, bones or other organs.
The overall prognosis for prostate cancer patients has dramatically improved compared with years ago. Over the past 20 years, the overall survival rates for all stages of prostate cancer have increased. Some of the possible reasons for this increase in survival rates include public awareness and early detection.
The purpose of screening for cancer is to detect the cancer at its earliest stages, before any symptoms have developed. The associated morbidity results in an important degradation of the quality of life of the prevalent patients, and the high incidence and prevalence along with the morbidity make it necessary to dedicate an enormous economical and social effort to treat the prostate cancer and its associated complications
Treatment options vary according to age and the stage of cancer including watchful waiting, surgery site-directed radiation and hormonal treatment. In recent years, the widespread use of the prostate specific antigen (PSA) for early detection of PCA has resulted in an increasing number of men diagnosed with organ-confined, low Gleason-score PCA. Tumour-caused lethality of PCA has decreased. However, the high sensitivity of the PSA (90%) determination is accompanied by a low specificity (35%), causing a large number of unnecessary biopsies.
Estimations state that may be as many as 50% of all cases are irrelevant prostate carcinoma diagnosed on the basis of elevated PSA alone. Therefore another very important topic to be addressed within UroSysteomics will be the level of aggressiveness of prostate carcinoma and the consequential necessity for treatment.