Editorial Comment

Abstract

Before the advent of testing for prostate-specific antigen (PSA), men presented with bone pain or palpable prostate nodules as the first sign of prostate cancer. Treatment was usually limited to hormonal therapy. For those fortunate men with localized disease, the preferred treatment was often radiation therapy, but this gradually gave way to radical prostatectomy (RP), especially for men with Gleason pattern ≤6 disease. Two decades of PSA testing have completely transformed this paradigm. The number of incident cases has more than doubled and most men now present with localized disease. For younger men, RP is the preferred treatment, but the rising number of men presenting with very low-volume, low-grade cancers has raised concerns about over-diagnosis and over-treatment. Rather than presenting with disease too late, they are presenting too early. Low Prostate-specific Antigen and No Gleason Score Upgrade Despite More Extensive Cancer During Active Surveillance Predicts Insignificant Prostate Cancer at Radical ProstatectomyUrologyVol. 80Issue 4PreviewTo identify parameters that predict insignificant prostate cancer in 67 radical prostatectomies after biopsy reclassification to worse disease on active surveillance. Full-Text PDF