Prostate cancer treatment and surveillance developments

Medical advancements and research trends in prostate cancer management are showing a shift toward more targeted and observational approaches.

Clinical developments include the use of theranostics, where molecular targets like Prostate-Specific Membrane Antigen (PSMA) are used for both staging and treatment. Diagnostic tools such as PSMA PET-CT scans assist in identifying lesions, while therapies like lutetium-177 are used for metastatic, castration-resistant cases. Surgical options include curative robotic radical prostatectomy, with specialists like Dr. André Berger pioneering robotic techniques for urological tumors.

Research indicates evolving strategies in treatment and surveillance. A study led by the UCLA Health Jonsson Comprehensive Cancer Center suggests that traditional indicators of aggressive tumors may not accurately predict which patients will benefit most from adding hormone therapy to radiation. This is a critical distinction, as hormone therapy can cause side effects such as metabolic changes, sexual dysfunction, and loss of bone strength.

There is a significant trend toward active surveillance for low-risk patients. Data involving over 73,000 veterans shows that the rate of active surveillance for low-risk diagnoses rose from 27% in 2005 to 93% in 2024. Additionally, the rate for patients with favorable intermediate risk rose from 14% in 2005 to 61% in 2024. This approach utilizes regular PSA blood tests, MRIs, and biopsies to monitor growth while avoiding the immediate side effects of surgery or radiation.

In Brazil, the National Cancer Institute (INCA) expects approximately 77,920 new cases annually between 2026 and 2028. While tools like the Prostate Health Index (PHI) are refining risk assessment, medical professionals note that cultural barriers and stigma regarding physical examinations often hinder early diagnosis.