CONTEMPORARY TREATMENT OF PROSTATIC CANCER
by
Dr Peter Lim Huat Chye, AM, MBBS, MMed(Surger), D.Urol(Lond), FICS, FAMS (Urology), M.I.Urol(Lond)(Hon), FCS (M'sia), Senior Consultant & Head, Division of Urology, Toa Payoh Hospital, SINGAPORE 1129.

INTRODUCTION:
Currently prostate cancer is managed according to the stage at which it presents to the urologist. The Stages are simply classed as:
STAGE A:
Cancer being latent or Occult STAGE B:
A nodule of cancer being limited to the interior of the gland STAGE C:
Cancer with loco-regional Spread STAGE D:
Locally advanced cancer with or without Distant Spread to Bones/Lungs etc
TREATMENT:
STAGE A:
Should be managed by observation
STAGE A2, B1 and B2:
May be treated surgically by Radical Retropubic or Perineal Prostatectomy. Alternatively Radical Radiotherapy can be given via External Beam or by the Interstitial Technique. Choice is dictated by the age of the patient, his fitness for surgery & the availability of surgical expertise. If younger than 65 & the patient has more than a`10 year life expectancy, the surgery approach is currently favoured for complete eradication of the disease.
STAGE C:
The preferred treatment is radiation therapy.
STAGE D:
Although bilateral Orchiectomy remains the main method at this stage of the disease, newer forms of therapy such as the use of Anti-androgens and LH-RH agonists or a combination of these is being increasingly preferred in situations where cost-considerations are not prohibitive.