Excerpt

Prostate cancer is one of the commonest cancers in men. Each year there are about 27,773 new cases in England and Wales, and 9161 deaths. Prostate cancer is predominantly a disease of older men but around 20% of cases occur in men under the age of 65. Over the past 10 to 15 years there have been a number of significant advances in its management but also a number of major controversies, especially about the clinical management of patients with early, non-metastatic disease. These uncertainties clearly cause anxieties for patients and their families. There is evidence of practice variation around the country and of patchy availability of certain treatments and procedures. A clinical guideline will help to address these issues and offer guidance on best practice.

Contents

• Foreword
• Key priorities
• Key research recommendations
• Recommendations
• Methodology
• Algorithms
• 1. Epidemiology
  • 1.1 Introduction
  • 1.2 Incidence
  • 1.3 Mortality
  • 1.4 Survival
  • 1.5 Diagnosis and Investigations
  • 1.6 Surgery
  • 1.7 Hormonal Therapy
  • 1.8 Radiotherapy
  • 1.9 The Findings of Cancer Peer Review of Urology Cancer Teams in England 2004 – 2007
  • References
• 2. Communication and support
  • 2.1 Introduction
  • 2.2 Communicating with Men with Prostate Cancer, their Partners and Carers
  • 2.3 Decision Support
  • 2.4 Specific Problems
  • References
• 3. Diagnosis and staging of prostate cancer
  • 3.1 When to Biopsy
  • 3.2 Histological Diagnosis
  • 3.3 Staging Classification for Prostate Cancer
  • 3.4 Nomograms
  • References
• 4. Localised prostate cancer
  • 4.1 Introduction
  • 4.2 Predictive Factors and Risk Groups
  • 4.3 Treatment Decision Making
  • 4.4 Initial Treatment Options
  • 4.5 Managing Adverse Effects of Treatment
  • 4.6 Follow-up
  • References
• 5. Managing relapse after radical treatment
  • 5.1 Introduction
  • 5.2 Defining Biochemical Relapse
  • 5.3 Assessment of Biochemical Relapse
  • 5.4 Management of Biochemical Relapse
  • References
• 6. Locally advanced prostate cancer
  • 6.1 Introduction
  • 6.2 Systemic Therapy
  • 6.3 Local Management of Locally Advanced Prostate Cancer
  • References
• 7. Metastatic prostate cancer
  • 7.1 Introduction
  • 7.2 Hormonal Therapy
  • 7.3 Androgen Withdrawal Versus Combined Androgen Blockade (CAB)
  • 7.4 Anti-androgen Monotherapy
  • 7.5 Intermittent Androgen Withdrawal
  • 7.6 Managing the Complications of Hormonal Therapy
  • 7.7 Hormone-Refractory Prostate Cancer
  • 7.8 Chemotherapy
  • 7.9 Oestrogens and Steroids
  • 7.10 Imaging
  • 7.11 Bone Targeted Therapies
  • 7.12 Pelvic Targeted Therapies
  • 7.13 Palliative Care
  • References
• Appendices
  • Appendix 1 Prostate Specific Antigen (PSA)
  • Appendix 2 TNM Staging for Prostate Cancer
  • Appendix 3 An Economic Evaluation of Radical Prostatectomy Versus Alternative Treatment Options for Clinically Localised Prostate Cancer
  • Appendix 4 Abbreviations
  • Appendix 5 Glossary
  • Appendix 6 Guideline Scope
  • Appendix 7 List of Topics Covered by Each Chapter
  • Appendix 8 People and Organisations Involved in Production of the Guideline
• Evidence review
  • Chapter 2 – Communication and Patient Centred Care
  • Chapter 3 – Diagnosis and Staging of Prostate Cancer
  • Chapter 4 – Localised Prostate Cancer
  • Chapter 5 –The Management of Relapse After Radical Treatment
  • Chapter 6 – Locally Advanced Prostate Cancer
  • Chapter 7 – Metastatic Prostate Cancer
  • Appendix A Position Paper. Prostate Cancer and the Effect It May Have On Masculinity
  • Appendix B Position Paper. Some views on radiation toxicity mechanisms, symptoms, aetiology and prevention
  • Appendix C Search Strategies

While every effort has been made to ensure the accuracy of the information contained within this publication, the publisher can give no guarantee for information about drug dosage and application thereof contained in this book. In every individual case the respective user must check current indications and accuracy by consulting other pharmaceutical literature and following the guidelines laid down by the manufacturers of specific products and the relevant authorities in the country in which they are practising.