Early prostatic cancer is asymptomatic and metastasis to the lung, bone, lymph nodes and liver are common. Early symptoms are those of urethral obstruction. The rectal exam, PSA test, and ultrasound are the best methods to detect prostate cancer. One half to three fourths of patients will benefit from treatment. Prostate cancer is most successfully treated when detected early.
Treatment is dependent on the stage of the disease, the patient's age, and symptoms.
Because prostatic cancer is a testosterone-responsive tissue, lowering serum testosterone is often an effective treatment. Andogenic antagonists such as cyproterone or flutamide are potent agents in previously untreated patients. GnRH analogs also reduce testosterone and produce response rates equvalent to those achieved with DES or castration. Side effects from these analogs are uncommon. The PSA test measures a normal blood-born protein made by the prostate.