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Overview of approach to prostate cancer survivors

Ted A Skolarus, MD, MPH, FACS
Section Editors
Larissa Nekhlyudov, MD, MPH
Jerome P Richie, MD, FACS
Deputy Editor
Michael E Ross, MD


Prostate cancer is the second most common cancer in men worldwide and the most common non-cutaneous malignancy in men within the United States. Although it is the third leading cause of cancer-related death in men after lung and colon cancer in the United States, cancer-specific survival is excellent for most patients [1]. Due to a generally older age at presentation, earlier detection, effective treatment, and a protracted clinical course for most men, prostate cancer survivors have a higher risk of death from non-cancer causes [2].

In the United States alone, over three million men are survivors of prostate cancer, comprising 43 percent of the total United States male cancer survivor population [3]. It is estimated that by 2024, prostate cancer survivors will exceed four million in number, highlighting the importance of collaboration between primary care providers and cancer specialists so that these patients' unique needs can be met efficiently [4].

This topic will discuss the approach to prostate cancer survivors and is focused on patients seen in a coordinated care setting between their primary care and oncology providers or those exclusively cared for by their primary care providers. For purposes of this discussion, cancer survivors are characterized as men who have been diagnosed with prostate cancer and have completed all treatment for prostate cancer. The approach presented in this topic is consistent with guidelines from the American Cancer Society [5], the American Society of Clinical Oncology (ASCO) [6], and the National Comprehensive Cancer Network (NCCN) [7].

Further information on the diagnosis, staging, and treatment of prostate cancer is discussed separately. (See "Clinical presentation and diagnosis of prostate cancer" and "Initial staging and evaluation of men with newly diagnosed prostate cancer" and "Prostate cancer: Risk stratification and choice of initial treatment".)


Diagnosis and staging — Over 90 percent of patients present with local or locoregional disease due to the widespread use of prostate cancer screening (ie, use of prostate-specific antigen [PSA] or digital rectal examination [DRE]) [8]. In the remainder of patients, the diagnosis is typically suspected based on symptoms of advanced cancer (eg, urinary tract obstruction, hematuria, bone pain). Regardless of clinical suspicion, the diagnosis of prostate cancer requires histologic confirmation. (See "Clinical presentation and diagnosis of prostate cancer".)

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Literature review current through: Nov 2017. | This topic last updated: Dec 06, 2017.
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