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PMID- 28655021
DA  - 20170627
DCOM- 20170711
LR  - 20170713
IS  - 1538-3598 (Electronic)
IS  - 0098-7484 (Linking)
VI  - 317
IP  - 24
DP  - 2017 Jun 27
TI  - The Diagnosis and Treatment of Prostate Cancer: A Review.
PG  - 2532-2542
LID - 10.1001/jama.2017.7248 [doi]
AB  - Importance: Prostate cancer is the most common cancer diagnosis made in men with 
      more than 160000 new cases each year in the United States. Although it often has 
      an indolent course, prostate cancer remains the third-leading cause of cancer
      death in men. Observations: When prostate cancer is suspected, tissue biopsy
      remains the standard of care for diagnosis. However, the identification and
      characterization of the disease have become increasingly precise through improved
      risk stratification and advances in magnetic resonance and functional imaging, as
      well as from the emergence of biomarkers. Multiple management options now exist
      for men diagnosed with prostate cancer. Active surveillance (the serial
      monitoring for disease progression with the intent to cure) appears to be safe
      and has become the preferred approach for men with less-aggressive prostate
      cancer, particularly those with a prostate-specific antigen level of less than 10
      ng/mL and Gleason score 3 + 3 tumors. Surgery and radiation continue to be
      curative treatments for localized disease but have adverse effects such as
      urinary symptoms and sexual dysfunction that can negatively affect quality of
      life. For metastatic disease, chemotherapy as initial treatment now appears to
      extend survival compared with androgen deprivation therapy alone. New vaccines,
      hormonal therapeutics, and bone-targeting agents have demonstrated efficacy in
      men with metastatic prostate cancer resistant to traditional hormonal therapy.
      Conclusions and Relevance: Advances in the diagnosis and treatment of prostate
      cancer have improved the ability to stratify patients by risk and allowed
      clinicians to recommend therapy based on cancer prognosis and patient preference.
      Initial treatment with chemotherapy can improve survival compared with androgen
      deprivation therapy. Abiraterone, enzalutamide, and other agents can improve
      outcomes in men with metastatic prostate cancer resistant to traditional hormonal
FAU - Litwin, Mark S
AU  - Litwin MS
AD  - Department of Urology, David Geffen School of Medicine, University of California,
      Los Angeles2Department of Health Policy and Management, Fielding School of Public
      Health, University of California, Los Angeles3School of Nursing, University of
      California, Los Angeles.
FAU - Tan, Hung-Jui
AU  - Tan HJ
AD  - Department of Urology, University of North Carolina, Chapel Hill.
LA  - eng
PT  - Journal Article
PT  - Review
PL  - United States
JID - 7501160
RN  - 0 (Androgen Antagonists)
RN  - 0 (Antineoplastic Agents)
RN  - EC (Prostate-Specific Antigen)
SB  - IM
MH  - Androgen Antagonists
MH  - Antineoplastic Agents/therapeutic use
MH  - Biopsy
MH  - Humans
MH  - Magnetic Resonance Imaging/methods
MH  - Male
MH  - Multimodal Imaging/methods
MH  - Neoplasm Grading
MH  - Prostate/pathology
MH  - Prostate-Specific Antigen
MH  - Prostatic Neoplasms/blood/*diagnosis/pathology/*therapy
MH  - Risk
MH  - Treatment Outcome
MH  - Ultrasonography/methods
EDAT- 2017/06/28 06:00
MHDA- 2017/07/14 06:00
CRDT- 2017/06/28 06:00
AID - 2633921 [pii]
AID - 10.1001/jama.2017.7248 [doi]
PST - ppublish
SO  - JAMA. 2017 Jun 27;317(24):2532-2542. doi: 10.1001/jama.2017.7248.