Treatment Decision in prostatic cancer

Treatment Decision in prostatic cancer ;

1- T1a ;

  • Incidentally found tumors at TURP, by defnition low volume (≤5%), usually well differentiated associated with very slow growth rate .
  • Managed by watchful waiting (Regular follow up with DRE and PSA) every 3 - 6 month.

2- localized T1b, T1c and T2 ;

  • Management depends on patient’s age, life expectancy, performance status and patient’s preference.
  • In younger, fitter men (<70 years): Radical prostatectomy or radiotherapy , if surgery is contraindicated
  • Elderly (>70 years) with life expectancy <10 years: Watchful waiting (Progress rate is very slow, 10% at 10 years)

3- Advanced disease (T3, T4 or any metastasis) ;

  • Palliative treatment, androgen ablation or palliative radiotherapy
  • Androgen ablation (Hormone therapy) is frst line of treatment: Orchiectomy + Flutamide or LHRH + Flutamide
  • Palliative radiotherapy .