Diagnosis and treatment of localized prostate cancer

Use of modern technology, especially the introduction of prostate specific antigen (PSA) testing, has led us to the new era of diagnosis and management of prostate cancer. Early diagnosis of prostate cancer has become increasingly possible and the chance of finding a localized disease has dramatically increased even in our country. Studies on a large series of patients diagnosed with the use of the PSA test, revealed that the proportion of locally confined disease can be increased to 60% or more. Modern imaging technology including transrectal ultrasound makes it possible to do more accurate disease staging. With recent understanding of the periprostatic anatomy and increasing number of localized disease patients, radical prostatectomy has gained popularity. On the other hand, the indications for radical prostatectomy are still controversial, especially for locally advanced prostate cancer. Conventional endocrine therapy still plays an important role in the subgroup of localized disease patients. We here discuss the current status and controversies in the diagnosis and treatment of localized prostate cancer