The clinically organ confined adenocarcinoma of the prostate

Dr. Hans-Peter Schmid's monograph delves into the fundamental dilemmas of prostate cancer, highlighting the stark contrast between a 40% histologic incidence of invasive cancer in men and a mere 3% death rate. It examines the notably slow doubling time of four to five years for untreated early clinical stages (T1 and T2 cancers) and the limited life expectancy of healthy men over 70. The text also engages with national and international treatment debates surrounding this cancer. Despite these uncertainties, prostate cancer stands out as one of the most predictable human solid tumors, a key point addressed by Dr. Schmid. He emphasizes that serum PSA levels and their rate of increase in untreated patients with prostate sizes under 50 grams are crucial for predicting cancer volume and grade. This is complemented by the assessment of the extent and percentage of grade 4 and 5 cancer from six systematic biopsies. While digital rectal examinations provide a clinical stage estimate, they lack the quantitative precision of PSA measurements and systematic biopsies. The Basel series presented in this work reinforces these foundational concepts, contributing valuable insights into the understanding and management of prostate cancer.