[Recent findings on the pathogenesis and therapy of prostatic cancer].

Presently, there is no effective therapy for increasing survival of metastatic prostatic cancer. New approaches to this major disease are, therefore, urgently needed. One approach is to study the biology of prostatic carcinogenesis in order to develop a therapeutic modality to prevent the development of clinically manifest prostatic cancer. Based upon international epidemiological data, it should be possible to lower the incidence of clinical prostatic cancer by more than 10-fold among the males of the western industrial states. An alternative approach is to study the tumor biology of prostatic cancer in order to identify new modalities to better treat already established clinical prostatic cancer. Such studies have already demonstrated that individual prostatic cancers are composed of clones of cancer cells which are phenotypically heterogeneous even before therapy is initiated. Due to this tumor cell heterogeneity, the direction of future studies should be towards combining androgen ablation plus chemotherapy early in the disease in order to affect both the androgen-dependent and -independent cancer cells present within individual prostatic cancers.