This text provides a comprehensive, state-of-the art review of this field, and will serve as a valuable resource for clinicians, surgeons and researchers with an interest in early prostate cancer. The book reviews new data about genetic markers, transperineal mapping biopsy and mpMRI, how to apply each of these technologies in patients with elevated PSA, when a prior prostate biopsy performed by the standard TRUS method is negative and in cases where low risk disease is already diagnosed, how to differentiate those men who might harbor more aggressive disease from those who do not. Over 75% of newly diagnosed prostate cancer meets the criteria for low risk disease which has created a dilemma for both patients and clinicians. Active surveillance programs have been initiated and are reviewed. How the new technologies impact surveillance programs is addressed. Clinical stage designation is updated and a new intra-prostatic staging system is discussed. Prostate biopsy techniques utilizing transrectal ultrasound, transperineal mapping, elastography and mpMRI are compared. Finally, utilization of this new technology in the application of focal therapy is reviewed.

The Prostate Cancer Dilemma will serve as a very useful resource for physicians and researchers dealing with, and interested in this challenging malignancy. Chapters are written by experts in their fields and include the most up to date scientific and clinical information as well as links to procedural video content.

Nelson N. Stone, MD.

Professor of Urology and Radiation Oncology

Department of Urology

The Icahn School of Medicine at Mount Sinai

New York, NY

USA

E. David Crawford, MD

Professor of Urology/Surgery and Radiation Oncology

University of Colorado

Denver, Aurora, CO

USA

Part One: Diagnosis.- History of PSA, from Detection to Over Diagnosis.- Pathology of Prostate Cancer: What has Changed in the Last 30 years?- Clinical Risk Prediction Tools for Prostate Cancer: TMN to CAPRA-Should Risk be Re-defined?- TRUS Biopsy: Is There Still a Role?- Transperineal Biopsy Technique.- 3D Biopsy: A New Method to Diagnose Prostate Cancer.- Elastography: Can it Improve Prostate Biopsy Results?- Multi parametric MRI of the Prostate as a Tool for Prostate Cancer Detection.- Genomic Markers.- Part Two: Treatment.- Current Status of Clinical Trials in Active Surveillance.- Focused targeted Therapy in Prostate Cancer.- Technologies and Methods in Primary Ablation with Focal Therapy.- Multi parametric MRI (mpMRI)-Guided Focal Therapy.- Conclusions.