Prostate Cancer Review

Ekaterina Kachur, PharmD


US Pharmacist. 2018;43(8):HS7-13. 

In This Article

Abstract and Introduction


Prostate cancer screening remains controversial, with most professional organizations endorsing shared decision-making and considerations of life expectancy as a general approach. Advances in risk stratification provide more precise prognosis and individualized treatment approaches. Active surveillance, surgery, and radiation remain the main treatment modalities for localized disease. For newly diagnosed metastatic disease, androgen-deprivation therapy is the standard of care. Chemotherapy as part of initial treatment appears to extend survival for certain risk groups. In the past decade, a number of novel agents have been shown to improve outcomes in men with castration-resistant prostate cancer.


Prostate cancer is the most common noncutaneous malignancy among men in the United States, with 3.3 million existing survivors and an estimated 161,000 new diagnoses in 2017.[1,2] Although prostate cancer is often a slow-growing malignancy, it remains the third leading cause of cancer deaths in men.[1,2] Most patients are asymptomatic at diagnosis; prior to the availability of prostate-specific antigen (PSA) testing, the most common presenting symptoms were urinary retention, back pain, bone pain, and hematuria.[3] Risk factors for prostate cancer include sub-Saharan African ancestry, family history, certain genetic mutations (BRCA 1 or 2), and older age.[3,4] Due to the indolent course of the disease and the morbidity associated with over-treatment, prostate cancer screening remains a controversial topic.[3] In the past decade, a number of advances have been made in characterizing disease risk and expanding therapeutic options. This review summarizes the principal approaches to prostate cancer screening, diagnosis, and treatment.