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Prostate Cancer: New Perspectives for the New Millennium Our awareness of prostate cancer, its diagnosis and available treatment options have increased tenfold in the last decade. At the beginning of this century, media exposure, both print and electronic, has focused public attention on this condition. Since the disease has been identified as the second leading cause of cancer-related mortality among American men, medical researchers and practitioners have increased their efforts to identify the populations most at risk, improve diagnostic tools and develop more effective therapies with fewer side effects. In the last several years, the issue of ethnicity as a factor in calculating risk statistics has been debated in the medical community. A number of recent studies tend to provide contradictory data. Some research has indicated that African American men may be more at risk for developing this kind of malignancy.However, when controlled for age and economic factors, other studies point out that comparisons between African American and Caucasian men's risk factors are not statistically significant. Still other trials found a difference between ethnic groups in the likelihood of receiving active treatment, although this gap appeared to be shrinking over the last few years. African American men may be more at risk for onset of the illness than their Caucasian counterparts, due largely to the lack of early identification and introduction of active treatment for the disease. Much of this disparity seems to be attributable to community structure and socioeconomic issues. Increased utilization of screening techniques and more aggressive and earlier intervention is closing the statistical margin between the ethnic groups. Another major area of discussion among medical professionals is how to best use the PSA screening process. PSA (prostate specific antigen) is an enzyme found in tissues in the prostate. High levels of this enzyme can indicate potential conditions in the prostate including early stage cancer. Most practitioners utilize a marker of 4 ng/ml to order a biopsy. Research has shown the likelihood of occurrence between 0 and 4 ng is about the same; above that measurement, the odds that cancer has been contracted are significantly increased. Some medical researchers feel, however, that the threshold should be lowered. Recent clinical analysis suggests that by reducing the level to 2.6 ng, the effectiveness of the screen to early detection increases by as much as 36 percent. With improvements in the screening process, these finding certainly justify additional clinical trials to see whether a newer standard should be recommended. Resources Penson, D. F. (2002). What's new in prostate cancer epidemiology, natural history, and treatment. [electronic version]. American Urological Association 97th Annual Meeting. PSA Best Practice Policy Task Force. (2000, February). Prostate-specific antigen (PSA) best practice policy. [electronic version]. Oncology, 14(2), 267-286. Retrieved August 30, 2002, from www.cancernetwork.com/journals/oncology/o0002e.htm.

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