Editorial [Hot Topic: New Therapies in Prostate Cancer: Controlling Metastatic Disease and Preventing Oncogenesis (Executive Editor: B.F. Schwartz )]

Prostate cancer continues to be a significant public health concern throughout the world. It remains the most common male cancer after skin cancer and leads to the second most number of male cancer deaths behind lung cancer. Almost 85% of all prostate cancers are diagnosed in the local or regional stages and the five-year relative survival rate for these men approaches 100%. Incidence rates over the last 30 years are only slightly higher. The introduction of prostate specific antigen (PSA) produced a tremendous rise in diagnosed cases in the early 1990's but was followed by a leveling off to an incidence not too different than the mid 1970's. Many patients however, are able to live longer with their disease thanks to treatment of metastatic disease. Breakthroughs in earlier diagnosis, aggressive early treatment, better adjuvant therapy for primary treatment failures and successful treatment for metastatic disease has greatly improved the quantity and quality of lives for prostate cancer patients. Also, tremendous breakthroughs in understanding the physiology of prostate endocrinology, mainly in the form of five alpha-reductase, have contributed to the diagnosis and management of prostate disease. The current issue of Current Pharmaceutical Design presents an excellent overview and current work on timely prostate cancer topics. Although not a lot of progress has been made on prostate cancer prevention, promising new areas of interest have surfaced. Five alpha reductase inhibitors successfully inhibit prostate cell proliferation and in preliminary studies may be prevent prostate cancer. Their effects on benign prostate disease are well known. Drs. Tarter and Vaughan [1] provide an excellent review of these agents, their mechanisms of action and their potential roles in prostate cancer prevention. The advent of PSA has greatly assisted the medical community in diagnosing, treating and following prostate cancer. PSA elevation after definitive local therapy continues to be challenging to patient and physician alike. Dr. Moul [2] provides a comprehensive review of various treatment options for this clinical entity based on his own experience and a review of the world literature. Successful treatment of metastatic prostate cancer has prolonged the lives of millions of men and improved the quality of their lives. Multiple regimens and treatment options exist for these patients but not without controversy. A thorough review of this topic is provided by Drs. Wilson and Crawford [3]. Finally, the last two papers represent some of the most exciting areas in all of cancer research: immunotherapy and chemotherapy. Traditionally, these two modalities have been ineffective in the treatment of prostate cancer. Dr. Karnes and his group [4] provide the current status and future directions of immunotherpy for prostate cancer while Dr. Malkowicz [5] discusses current breakthroughs and the future promises of chemotherapy in the treatment of prostate cancer. It is with the assistance of these authors that scientific progress is made in the treatment of a disease that kills roughly 100,000 men worldwide per year. They are to be congratulated for their work and I thank them sincerely for their contributions. References [1] Tarter TH, Vaughan Jr, ED. Inhibitors of 5a-Reductase in the Treatment of Benign Prostatic Hyperplasia. Curr Pharm Design 2006; 12(7): 775-783. [2] Moul JW. Treatment of PSA only Recurrence of Prostate Cancer After Prior Local Therapy. Curr Pharm Design 2006; 12(7): 785-798. [3] Wilson SS, Crawford ED. Controversies of Androgen Ablation Therapy for Metastatic Prostate Cancer. Curr Pharm Design 2006; 12(7): 799-805. [4] Karnes RJ, Whelan CM, Kwon ED. Immunotherapy for Prostate Cancer. Curr Pharm Design 2006; 12(7): 807-817. [5] Dyrstad SW, Shah P, Rao K. Chemotherapy for Prostate Cancer. Curr Pharm Design 2006; 12(7): 819-837.