Diagnostic et suivi du cancer de la prostate

Incidence of prostate cancer shows a very steep increase with age, and epidemiology of this cancer includes demographic consideration, environmental, nutritional and genetic factors. Natural history of the tumor varies greatly among patients, from localized non symptomatic and slow growing cancers to aggressive tumors leading to a metastatic extension. Criteria of tumoral aggressiveness are currently under investigation to better understand the physiopathology of this cancer. Management of prostate cancer depends on cancer extension as judged by clinical examination, prostatic biopsies and imaging techniques. In patients with small volume well-differentiated clinically localized cancers, whose life expectancy is less than 10 years, surveillance may be an option. Radical prostatectomy or conformational radiotherapy may be performed in cancers confined to the prostate. When stadification reveals extraprostatic extension of the tumor spreading out of the gland, androgen deprivation is usually indicated. Treated prostate cancer follow-up is based on PSA assay.