Abstract
1Division of Urology, Department of Surgery, Denver Health Medical Center, University of Colorado School of Medicine, Denver CO, USA; 2University of Colorado Cancer Center, UC Denver. Denver CO, USA ___________________________________________________________________________________
Highlights
The CancerIn the era of PSA screening, prostate cancer faced a dramatic increase in incidence. Early detection of asymptomatic disease leads to majority of patients being diagnosed at earlier clinical stages [1]
Overtreatment and Less Invasive aggressive therapy for Localized Prostate cancer In the PSA era, overtreatment of prostate cancer patients became a clinical and public health controversy
In addition one cannot forget the emotional burden of the diagnosis of cancer and anxiety that frequently drives patients in active surveillance to seek for active treatment [11]
Summary
In the era of PSA screening, prostate cancer faced a dramatic increase in incidence. Early detection of asymptomatic disease leads to majority of patients being diagnosed at earlier clinical stages [1]. The lack of aggressive treatment after diagnosis of cancer may lead 50% of patients enrolled in watchful waiting cross to active treatment in a period of 5 years post-diagnosis [5, 6]. Another issue is the limitations of ultrasound guided biopsies that cannot accurately grade the disease since the pathological upgrade of prostate specimens after radical prostatectomy is often seen when compared to pre-operative pathological findings [7,8,9,10]. A total of 86% of the patients had negative biopsies during the follow-up [27]
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