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The cause of prostatic cancer is unknown, and few specific environmental or viral agents have been linked with the tumor. Increased recognition of the importance of frequent digitial rectal examination has resulted in more tumors being diagnosed in early stages. Developments in sonography suggest that it may be useful in detecting the presence of prostatic cancer and whether extraprostatic extension has occurred. Recent improvements in the sensitivity of prostatic acid phosphatase assays have been made, but their use as a screening tool remains limited. In patients with clinical stage B lesions that are microscopically confined to the prostate, treatment by radical prostatectomy appears to confer greatest survival. The exact role of radiotherapy remains to be defined. However, when the tumor extends beyond the prostate and is localized to the pelvis, external beam or interstitial radiation is appropriate. Pelvic lymphadenectomy has significant morbidity, but less invasive methods of pelvic nodal evaluation are less accurate. Lymphadenectomy has not been shown to have any therapeutic effect. Whether hormonal therapy improves survival needs further investigation, and efforts must continue to develop means of predicting hormonal responsiveness. Those patients unlikely to respond to hormonal therapy should be treated with early chemotherapy.<\/jats:p>","DOI":"10.1002\/pros.2990010304","type":"journal-article","created":{"date-parts":[[2007,2,20]],"date-time":"2007-02-20T23:38:44Z","timestamp":1172014724000},"page":"287-301","source":"Crossref","is-referenced-by-count":3,"title":["Overview of past and current philosophy of prostatic cancer"],"prefix":"10.1002","volume":"1","author":[{"given":"Jack S.","family":"Elder","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"William W.","family":"Scott","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leroy M.","family":"Nyberg","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2006,7,20]]},"reference":[{"key":"e_1_2_1_2_2","first-page":"293","article-title":"Studies of prostatic cancer. I. 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