Active surveillance represents a viable option in men with low-risk PCa and a long life expectancy .
A biopsy progression indicates the need for active intervention , whereas the role of PSA doubling time is controversial .
In men with locally advanced PCa for whom local therapy is not m and atory , watchful waiting ( WW ) is a treatment alternative to and rogen-deprivation therapy ( ADT ) , with equivalent oncologic efficacy .
Active treatment is recommended mostly for patients with localized disease and a long life expectancy , with radical prostatectomy ( RP ) shown to be superior to WW in prospect i ve r and omized trials .
Nerve-sparing RP is the approach of choice in organ-confined disease , while neoadjuvant ADT provides no improvement in outcome variables .
For locally advanced disease , adjuvant ADT for 3 yr results in superior rates for disease-specific and overall survival and is the treatment of choice .
Active surveillance is an option in low-risk PCa and watchful waiting is an alternative to and rogen-deprivation therapy in locally advanced PCa not requiring immediate local treatment .
CONTEXT The most recent summary of the European Association of Urology ( EAU ) guidelines on prostate cancer ( PCa ) was published in 2011 .
OBJECTIVE To present a summary of the 2013 version of the EAU guidelines on screening , diagnosis , and local treatment with curative intent of clinical ly organ-confined PCa .
Current evidence is insufficient to warrant widespread population -based screening by prostate-specific antigen ( PSA ) for PCa .
Systematic prostate biopsies under ultrasound guidance and local anesthesia are the preferred diagnostic method .
CONCLUSIONS Knowledge in the field of PCa is rapidly changing .
Vitamin E and the risk of prostate cancer: the Selenium and Vitamin E Cancer Prevention Trial (SELECT).
CONTEXT The initial report of the Selenium and Vitamin E Cancer Prevention Trial ( SELECT ) found no reduction in risk of prostate cancer with either selenium or vitamin E supplements but a statistically nonsignificant increase in prostate cancer risk with vitamin E. Longer follow-up and more prostate cancer events provide further insight into the relationship of vitamin E and prostate cancer . OBJECTIVE To determine the long-term effect of vitamin E and selenium on risk of prostate cancer  in relatively healthy men . DESIGN , SETTING , AND PARTICIPANTS A total of 35,533 men from 427 study sites in the United States , Canada , and Puerto Rico were r and omized between August 22 , 2001 , and June 24 , 2004 . Eligibility criteria included a prostate-specific antigen ( PSA ) of 4.0 ng/mL or less , a digital rectal examination not suspicious for prostate cancer , and age 50 years or older for black men and 55 years or older for all others . The primary analysis included 34,887 men who were r and omly assigned to 1 of 4 treatment groups : 8752 to receive selenium ; 8737 , vitamin E ; 8702 , both agents , and 8696 , placebo . Analysis reflect the final data collected by the study sites on their participants through July 5 , 2011 . INTERVENTIONS Oral selenium ( 200 μg/d from L-selenomethionine ) with matched vitamin E placebo , vitamin E ( 400 IU/d of all rac-α-tocopheryl acetate ) with matched selenium placebo , both agents , or both matched placebos for a planned follow-up of a minimum of 7 and maximum of 12 years . MAIN OUTCOME MEASURES Prostate cancer incidence . RESULTS This report includes 54,464 additional person-years of follow-up and 521 additional cases of prostate cancer since the primary report . Compared with the placebo ( referent group ) in which 529 men developed prostate cancer , 620 men in the vitamin E group developed prostate cancer ( hazard ratio [ HR ] , 1.17 ; 99 % CI , 1.004 - 1.36 , P = .008 ) ; as did 575 in the selenium group ( HR , 1.09 ; 99 % CI , 0.93 - 1.27 ; P = .18 ) , and 555 in the selenium plus vitamin E group ( HR , 1.05 ; 99 % CI , 0.89 - 1.22 , P = .46 ) . Compared with placebo , the absolute increase in risk of prostate cancer per 1000 person-years was 1.6 for vitamin E , 0.8 for selenium , and 0.4 for the combination . CONCLUSION Dietary supplementation with vitamin E significantly increased the risk of prostate cancer among healthy men . TRIAL REGISTRATION Clinical trials.gov Identifier : NCT00006392
Active surveillance represents a viable option in men with low-risk PCa and a long life expectancy .
A biopsy progression indicates the need for active intervention , whereas the role of PSA doubling time is controversial .
In men with locally advanced PCa for whom local therapy is not m and atory , watchful waiting ( WW ) is a treatment alternative to and rogen-deprivation therapy ( ADT ) , with equivalent oncologic efficacy .
Active treatment is recommended mostly for patients with localized disease and a long life expectancy , with radical prostatectomy ( RP ) shown to be superior to WW in prospect i ve r and omized trials .
Nerve-sparing RP is the approach of choice in organ-confined disease , while neoadjuvant ADT provides no improvement in outcome variables .
For locally advanced disease , adjuvant ADT for 3 yr results in superior rates for disease-specific and overall survival and is the treatment of choice .
Active surveillance is an option in low-risk PCa and watchful waiting is an alternative to and rogen-deprivation therapy in locally advanced PCa not requiring immediate local treatment .
CONTEXT The most recent summary of the European Association of Urology ( EAU ) guidelines on prostate cancer ( PCa ) was published in 2011 .
OBJECTIVE To present a summary of the 2013 version of the EAU guidelines on screening , diagnosis , and local treatment with curative intent of clinical ly organ-confined PCa .
Current evidence is insufficient to warrant widespread population -based screening by prostate-specific antigen ( PSA ) for PCa .
Systematic prostate biopsies under ultrasound guidance and local anesthesia are the preferred diagnostic method .
CONCLUSIONS Knowledge in the field of PCa is rapidly changing .