Guidelines on Management of Prostate Cancer

therapeutic option has different risk-benefi t profi les.Hence the rationale, indications, risks and benefi ts are presented to assist the clinician in his discussion with his patient.The committee favours this open discussion strategy over explicit and potentially dogmatic emphasis on certain therapeutic strategies.Other novel therapies currently used in Singapore are also included and specifi cally highlighted for selective risk groups only.A detailed statement as to the investigative nature of these therapies is also included.Published data on cost-benefi t issues for prostate cancer in Singapore are currently lacking and cost discussions differ in different institutions with varying extent of government subsidies and service grants.Hence cost considerations were not included in this set of guidelines. Defi nition of Terms Early Prostate CancerThis refers to clinically localised prostate cancer without evidence of regional lymph node and distant metastasis.Treatment is mainly with curative intent in patients with longer life expectancy and minimal comorbidity. Locally Advanced Prostate CancerThis refers to clinically locally advance prostate cancer (≥T3b) with or without lymph node invasion within the pelvis.Treatment requires aggressive local multimodality therapy with surgery and/or defi nitive radiation therapy, combined either with or without androgen deprivation therapy. Metastatic Prostate CancerThis refers to prostate cancer with lymph node invasion beyond the pelvis and/or bony or visceral spread.Treatment