Survival With Conservative Therapy

Carcinoma of the prostate which has not extended beyond the prostatic capsule is designated as a localized lesion, and can be entirely removed by total prostatectomy. Extension beyond the capsule may be undetectable by gross examination, either by rectal palpation or by gross examination of the specimen after removal. Malignant cells may penetrate the capsule by extension along the perineural sheaths or by other routes and may be demonstrated only by histopathologic examination. Early prostatic cancer causes no symptoms and is discovered by palpation of a hard nodule by digital examination through the anterior rectal wall, and/or by finding a localized or focal lesion during histopathologic examination of tissue removed at the time of prostatectomy for supposed benign hyperplasia. Approximately one half of the hard nodules discovered by palpation are malignant30; the others are areas of inflammatory induration, fibrosis, or calculi. Therefore, in order to make a definite diagnosis