Prostate Cancer

Prostate Cancer

Research advances over the last 40 years have helped to make prostate cancer one of the most treatable of all cancers. Today, nearly all men who are in otherwise good health live at least five years after a prostate cancer diagnosis, up from 65 percent in the 1970s.

However, important research challenges remain. Recent trials have questioned the value of routine PSA testing to screen for prostate cancer, and researchers continue to search for a screening test that can accurately detect high-risk cases of the disease. New treatments are urgently needed for men with advanced stages of the disease, for whom survival remains low. In addition, racial disparities in prostate cancer mortality point to the need for better knowledge of the biology of prostate cancer, and improved access to care for many with the disease.

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1997

Adding hormone therapy to radiation improves prostate cancer survival

1996

New treatment for prostate cancer that resists hormone therapy

1994

Watchful waiting introduced for men with early prostate cancer

Watchful waiting introduced for men with early prostate cancer

Prostate cancer often grows very slowly, and many tumors that are discovered in an early stage will never grow to the point of being life-threatening. To help avoid unnecessary treatments, doctors begin to practice watchful waiting (also called active surveillance), in which treatment is delayed or replaced by frequent exams and PSA testing for men with early-stage disease. This approach helps them identify patients whose cancer is more aggressive and requires treatment, while sparing others from the complications of unnecessary treatment.

1990

Laparoscopic prostate cancer surgery introduced

Laparoscopic prostate cancer surgery introduced

Laparoscopic prostatectomy involves removing the prostate through multiple small incisions and a telescoping camera device. The approach reduces the recovery time and complications of surgery, compared to traditional "open surgery" through a single large incision. While laparoscopic prostatectomy has become common practice, randomized trials are still needed to show conclusively that this minimally invasive technique provides the same long-term effectiveness as traditional open surgery.

1987

New prostate cancer subtype identified

New prostate cancer subtype identified

Badge indicating that research was paid for using federal funds

Researchers identify a specific sub-set of prostate tumors known as neuroendocrine tumors (also called small-cell tumors). Subsequent research shows that neuroendocrine cancers grow and react to treatment differently than adenocarcinomas, the more common form of prostate cancer. They are more difficult to detect and they tend to spread to soft tissue rather than bone, but are generally responsive to chemotherapy. Today, doctors can identify these tumors by their genetic signature and tailor treatment accordingly.

1986

FDA approves PSA test for prostate cancer screening

FDA approves PSA test for prostate cancer screening

Badge indicating that research was paid for using federal funds

The FDA approves the first PSA (prostate-specific antigen) test to screen for prostate cancer in men aged 50 and older. PSA is a protein produced by cells in the prostate gland, and is often elevated in men with prostate cancer. Widespread use of PSA testing leads to a significant jump in early-stage prostate cancer diagnoses, sparking a debate that continues today about whether such screening improves survival or simply leads to over-diagnosis and treatment of cancers that would never have become life-threatening.

1982

Early hormone therapy drugs introduced

Early hormone therapy drugs introduced

Studies demonstrate the effectiveness of treatments known as luteinizing hormone receptor hormone antagonists (LHRHa therapy). These drugs – the first of which is approved by the FDA three years later – chemically reduce the production of testosterone and are used to slow the growth of prostate cancer, which is fueled by male sex hormones. The new approach is reversible, and thus preferable to the other options available at the time, including surgical removal of the testicles. Hormone therapy is now a standard approach for treating the disease.

New surgical approach helps preserve sexual and urinary function

1981

CT scanning proves useful for staging of prostate cancer

CT scanning proves useful for staging of prostate cancer

Following the introduction of computed tomography (CT) in the 1970s, studies begin showing that the new imaging technology can be used to determine the stage of a patient's prostate cancer without invasive techniques. CT scanning later proves useful to guide surgery and radiation therapy, and to help determine the optimal placement of radioactive "seeds" for patients who undergo a radiation treatment known as brachytherapy.

1980

New tools enable detection of early-stage prostate cancer

New tools enable detection of early-stage prostate cancer

Badge indicating that research was paid for using federal funds

Doctors begin using prostate ultrasound – in which sound waves are used to generate an image of the prostate – to detect abnormalities that may signal cancer. Together with a type of biopsy, in which a thin, hollow needle is used to extract prostate tissue for testing, doctors are far more able to detect the earliest stages of prostate cancer.

1974

Modern system for "staging" prostate cancer is introduced

Modern system for "staging" prostate cancer is introduced

Badge indicating that research was paid for using federal funds

The newly-created Gleason scoring system provides a uniform way for doctors to classify men's tumors by stage (low aggressiveness to high aggressiveness) and select appropriate treatments accordingly. The system is based on how prostate tumor cells look under a microscope on a scale of 1 through 5 (a low score indicates that cells look less malignant). This useful staging system has been updated and refined in recent decades, based on greater understanding about the disease's development and growth.

1971

Early prostate cancer screening regimen introduced

Early prostate cancer screening regimen introduced

Studies show that screening with annual rectal exams, followed by surgery to remove the prostate in men who are found to have cancer, enables men with the disease to live as long, on average, as those without cancer. However, such treatment comes at the expense of urinary continence and sexual function.

1970

Radioactive "seeds" proven effective for prostate tumors

Radioactive "seeds" proven effective for prostate tumors

A highly focused approach to radiation treatment, called brachytherapy, is shown to extend the lives of patients with prostate cancer, compared to surgical removal of the prostate and surrounding tissue. In this approach, tiny radioactive sources or "seeds" are implanted directly into the prostate gland. These seeds deliver a high dose of radiation directly to the tumor, while leaving healthy tissue beyond the prostate relatively unaffected, ushering in more focused alternatives to standard external beam radiation.

1966

First standard chemotherapy regimens for prostate cancer