Prostate cancer: diagnostic and therapeutic strategies with emphasis on the role of PSA.

Prostate cancer is the most common cancer in man and the second most common cause of death. The disease is uniquely heterogeneous, and includes tumors with moderate or full differentiation that could progress rather slowly, and tumors with poor differentiation that could have a rapid growth and extensive spread beyond the confines of the prostate. In the latter group of patients, and if they are not treated, the cancer becomes incurable and the long-term survival is compromised. The commonly accepted strategy among urologists at present is aimed at early detection of prostate cancer in order to provide curative local therapy. The recognition of prostate specific antigen (PSA) as a serum marker specific for prostate cancer has made this strategy possible. We herein provide an overview on the contemporary diagnostic and therapeutic strategies for prostate cancer, with emphasis on the role of prostate PSA. We also discuss the therapeutic options for localized disease.