The value of screening for prostate cancer, the second most common cancer in men, has been fiercely debated in recent years, but Professor Bolla from the Department of Radiotherapy, Centre Hospitalier de Grenoble, France, has no doubt that early detection is of prime importance in the treatment of prostate cancer.
The best way to save lives in prostate cancer is to make the diagnosis as soon as possible by the use of the prostate-specific antigen test before the disease has spread beyond the prostate gland, said Professor Bolla at the 1997 European Cancer Conference.
Presenting an opposing view, Dr. Joost Weyler of the Department of Epidemiology, University of Antwerp, Belgium suggests that the negative effects of screening for prostate cancer outweigh the positive effects.
Prostate cancer remains difficult to detect in its early stages, said Dr. Weyler. Existing screening methods (including digital rectal examination, prostate-specific antigen [PSA] screening, and transrectal ultrasonography) lack the validity needed for use in general populations. Prostate cancer screening might further our understanding of the natural history of prostate cancer, but, at present, we cannot tell which tumors are potentially aggressive. What is the point of diagnosing early prostate cancer when more men die with prostate cancer than from the disease?
Genetic advances in prostate cancer may soon alter the face of screening in prostate cancer, according to Dr. Norman Maitland of the Cancer Research Unit, University of York, United Kingdom. A number of promising loci have been identified on human chromosome 1 for familial prostate cancer and on chromosomes 8, 10, and 16 for sporadic prostate cancers, even though no genes directly predisposing to prostate cancer have yet been isolated, says Dr. Maitland.
It is clear that there is a genetic component in prostate cancer with possibly significant differences between the familial form that affects younger patients and the sporadic form that affects older patients. Identifying the genes involved in prostate cancer should bring untold benefits to the fields of diagnosis and treatment, Dr. Maitland concludes.
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