Novel approaches for the treatment of prostate cancer

It is estimated that in 2007 over 27,000 men in the USA will die of prostate cancer, making this disease second only to lung cancer in terms of cancer-specific mortality [1]. The growing practice of screening for prostate-specific antigen has led to increasing numbers of patients being diagnosed with local disease and more patients undergoing treatment with either surgery or local radiation. However, a number of men with newly diagnosed prostate cancer have a more indolent form of disease, which raises questions about optimal treatment strategies. This issue of Therapy reviews several novel strategies for treating select populations of patients with newly diagnosed and advanced stages of prostate cancer. Approximately 20–40% of prostate cancer patients who receive definitive local therapy will develop recurrent disease, manifested by rising serum prostate-specific antigen, and many will then undergo hormonal treatment. Patients with clinically localized prostate cancer who fail treatment with either radiotherapy or brachytherapy have limited treatment options. Among the novel approaches reviewed and discussed by Polascik in this issue are cryoablation, high-intensity focused ultrasound, photodynamic therapy and focal therapy [2]. Ismail et al. discuss two new concepts in adjuvant therapy – cryoimmunotherapy and cryochemotherapy. These experimental techniques can potentially be performed with minimal toxicity to patients and show promise for improving upon standard cryotherapy as a single modality [3]. A number of high-risk prostate cancer patients will develop either biochemical relapse or overt metastatic disease. While these patients can initially be treated with androgendeprivation strategies, the vast majority will eventually develop androgen-independent