Date:2009/1/29/(thu) 14:30-

Place:Room Ew-305, E Block,IIS, The University of Tokyo

Speaker:Dr. S. Larry Goldenberg(Department of Urologic Sciences, University of British Columbia)


Title:Appreciating the Natural History of Prostate Cancer


Abstract:

For many years, prostate illness was relegated to the “aging males” bin,
deriving little support from non-urologic clinical disciplines, researchers
or funding agencies.  But in the past two decades, we have witnessed a
remarkable resurgence of academic interest in the investigation and
treatment of prostate illness and a flourishing of educational and research
activities. The care of the prostate patient has become truly
multidisciplinary - urologists, family practitioners, medical oncologists,
radiation oncologists, nursing and other allied healthcare disciplines, with
a resulting paradigm of successful care.

Prostate cancer is a significant biological, medical and personal challenge
for millions of men. Each year, it affects close to a million men around the
world and hundreds of thousands die, usually after suffering months to years
of local and systemic morbidity.
Over the past 2 decades, important progress has been made in understanding
prostate cancer prevention, detection, prognosis and treatment. Imaging
technology continues to evolve at both anatomic and molecular levels.  We
have nomograms, new PSA isoforms, treatment algorithms, growing bodies of
evidence supporting nutritional and chemopreventive strategies, phase 3
studies of multimodal treatment for advanced disease, new chemotherapeutics,
biologics and bisphosphonates, all leading to a new standard of care.  But
most important, we have seen a 32% decline in prostate mortality.

Yet two very important challenges remain. We must learn to identify those
men with early disease who truly need to be actively treated, so as to
balance overdiagnosis and overtreatment against the potential morbidity from
aggressive cancer.  And at the other extreme of cancer biology, we need to
identify and target molecular pathways responsible for cancer morbidity and
mortality. This presentation summarizes the rapidly changing field of
prostate cancer biology, with emphasis on detection, prognosis, prevention,
treatment and future challenges.  The biology of prostate cancer is diverse
and complex - truly, no two cases are alike and the art of medicine is
critical in maximizing an individual’s opportunity for disease control,
cure and quality of life.