Abstract
The management of prostate cancer which is common in the elderly is problematic and remains controversial. Patient selection may have a crucial role in predicting outcome, because of death from other causes may occur before death from prostate cancer in many cases. The best approach may be to have patients choose a therapy after being well informed of the outcome including the relative risks and benefits from each treatment option. Assessment of treatment outcome has become more sensitive and rapid after serum prostate specific antigen (PSA) is available in routine follow-up. PSA has identified substantially more failure following all radical therapies than was previously detected, which is reporting long-term outcome with cure rates well below 40% not only for surgery but also radiation. Though watchful waiting or conservative management is frequently criticized as a poor option, it maybe a valid option for all men regardless of age or health status. However, radical prostatectomy still offers the best opportunity to cure the disease Because of uncertainty of therapeutic benefit and variation in practice patterns etc, practice guideline development is needed.
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