Prostate Cancer is a considerable health risk for men throughout the world. Screening with PSA has led to an increasing number of patients diagnosed with small volume, low grade cancer. Since many of this cancers grow slowly and, even if untreated, never progress to symptomatic disease, patients and clinicians face the dilemma of if, when and how to treat localized prostate cancer. While surgery and irradiation each provide excellent long-term cancer control, they are accompanied by a risk of side effects that decrease quality of life. Conversely, the appeal of watchful waiting strategies is offset by the lack of validated means (imaging, pathology of biopsy, laboratory and molecular tests) to identify appropriate candidates, monitor progression and initiate delayed therapy without compromising chances of cure. Consequently, a percentage of men who have cancer with biologically indolent features is over treated. On the other side in patients with low PSA and low volume disease understaging and under treatment have been reported.
Forum: Prostate Cancer: Latent versus Clinically Significant Disease: Does Every Cancer Need Intervention?

William J. Catalona. Northwestern Univ., Chicago, IL

Peter T. Scardino. Mem. Sloan-Kettering Cancer Ctr., New York, NY,