Prostatakreft
Sist oppdatert: Sist revidert:
Sist revidert av:Wolfgang Lilleby
Definisjon:
Som regel adenokarsinom. Økt risiko for tilstanden ved arvelig faktor og ved høy alder
Forekomst:
Den hyppigste kreftformen blant menn. Insidensen er høy, med 4850 nye tilfeller i Norge i 2018. Dette året døde 926 personer av sykdommen i Norge
Symptomer:
Kan mangle helt. Etter hvert ofte vannlatingsplager, men ingen sikker sammenheng mellom nedre urinveissymptomer (LUTS) og behandlingstrengende prostatakreft
Funn:
I tidlig fase ofte fravær av kliniske funn. Etter hvert kan palpasjon hos noen avdekke knuter eller uregelmessigheter i prostatas overflate
Diagnostikk:
PSA-test ved klinisk mistanke. PSA-screening kun etter å drøfte fordeler og ulemper nøye. Prostatabiopsi er nødvendig for diagnosen, men utredning med mpMR innenfor pakkeforløp bør tas før biopsering ved klinisk mistanke
Behandling:
Pasient- og tumorspesifikke forhold avgjør behovet for videre behandling. Behandlingsalternativene strekker seg fra aktiv overvåkning til kurativ kirurgisk og/eller strålebehandling, hormonbehandling, symptomstyrt behandling («watchful waiting») og palliativ behandling
- Nasjonalt handlingsprogram med retningslinjer for diagnostikk, behandling og oppfølging av prostatakreft. Helsedirektoratet. Sist faglig oppdatert 01. nov. 2021. Siden besøkt 13.02.2022. www.helsedirektoratet.no
- Mazhar D, Waxman J. Prostate cancer. Postgrad Med J. 2002 Oct;78(924):590-5. PMID: 12415080 PubMed
- Sehn JK. Prostate Cancer Pathology: Recent Updates and Controversies. Mo Med. 2018 Mar-Apr;115(2):151-155. PMID: 30228708 PubMed
- Epstein JI, Amin MB, Reuter VE, Humphrey PA. Contemporary Gleason Grading of Prostatic Carcinoma: An Update With Discussion on Practical Issues to Implement the 2014 International Society of Urological Pathology (ISUP) Consensus Conference on Gleason Grading of Prostatic Carcinoma. Am J Surg Pathol 2017; 41(4): e1-e7. pmid:281777964 PubMed
- Kreftregisteret. Cancer in Norway 2019. Oslo: Kreftregisteret, 2020, www.kreftregisteret.no.
- Lichtenstein P, Holm NV, Verkasalo PK, et al. Environmental and heritable factors in the causation of cancer -- analyses of cohorts of twins from Sweden, Denmark, and Finland. N Engl J Med 2000;343:78-85. PMID: 10891514 PubMed
- Jakobsen H. Prostatakræft, kirurgisk behandling af lokaliseret sygdom - nutidens og fremtidens udfordring. Ugeskr Læger 2008; 170: 2543. PubMed
- Wilt TJ, Thompson IM. Clinically localised prostate cancer. BMJ 2006; 333: 1102-6. PubMed
- Chazelas E, Pierre F, Druesne-Pecollo N, et al. Nitrites and nitrates from food additives and natural sources and cancer risk: results from the NutriNet-Santé cohort. Int J Epidemiol 2022. pmid:35303088 PubMed
- Helsedirektoratet. Diagnoseveiledere. Prostatakreft. Sist faglig oppdatert 02. august 2018. www.helsedirektoratet.no
- Legeforeningen. Gjør kloke valg. Anbefalinger. Siden besøkt 11.02.2021 www.legeforeningen.no
- Schroder FH, Hugosson J, Roobol MJ, et al. Screening and prostate cancer mortality: results of the European Randomised Study of Screening for Prostate Cancer (ERSPC) at 13 years of follow-up. Lancet. 2014 doi: 10.1016/S0140-6736(14)60525-0 DOI
- Andriole GL, Crawford ED, Grubb RL, et al. Prostate cancer screening in the randomized prostate, lung, colorectal, and ovarian cancer screening trial: mortality results after 13 years of follow-up. J Natl Cancer Inst 2012; 104: 125-32. PubMed
- Schröder FH, Hugosson J, Roobol MJ, et al. Screening and prostate-cancer mortality in a randomized european study. N Engl J Med 2009; 360: 1320-8. New England Journal of Medicine
- Tsodikov A, Gulati R, Heijnsdijk EAM, et al. Reconciling the Effects of Screening on Prostate Cancer Mortality in the ERSPC and PLCO Trials . Ann Intern Med 2017. pmid:28869989 PubMed
- Hamdy FC, Donovan JL, Lane JA1, et al. 10-Year Outcomes after Monitoring, Surgery, or Radiotherapy for Localized Prostate Cancer. N Engl J Med 2016; 375: 1415/24. pmid:27626136 PubMed
- Hugosson J, Roobol MJ, Månsson M, et al. A 16-yr Follow-up of the European Randomized study of Screening for Prostate Cancer. Eur Urol 2019; 76: 43-51. pmid:30824296 PubMed
- Carlsson S, Assel M, Sjoberg D, et al. Influence of blood prostate specific antigen levels at age 60 on benefits and harms of prostate cancer screening: population based cohort study. BMJ 2014; 348: g2296. BMJ (DOI)
- Gelfond J, Choate K, Ankerst DP, et al. Intermediate-term risk of prostate cancer is directly related to baseline prostate specific antigen: Implications for reducing the burden of prostate specific antigen screening. J Urol 2015 Jul; 194:46. PMID: 25686543 PubMed
- de Carvalho TM, Heijnsdijk EAM, de Koning HJ. Comparative effectiveness of prostate cancer screening between the ages of 55 and 69 years followed by active surveillance. Cancer 2018; 124: 507-13. pmid:29231973 PubMed
- Bryant AK, Lee KM, Alba PR, et al. Association of Prostate-Specific Antigen Screening Rates With Subsequent Metastatic Prostate Cancer Incidence at US Veterans Health Administration Facilities. JAMA Oncol 2922. pmid:36279204 PubMed
- Stark JR, Mucci L, Rothman KJ, Adami H-O. Screening for prostate cancer remains controversial. BMJ 2009; 339: b3601. BMJ (DOI)
- American Urological Association (AUA) Guideline. Early detection of prostate cancer: AUA guideline. 2013.
- Grossman DC, Curry SJ, Owens DK, et al. Screening for Prostate Cancer: US Preventive Services Task Force Recommendation Statement.. JAMA 2018; 319: 1901-13. pmid:29801017 PubMed
- Van der Cruijsen-Koeter, van der Kwast TH, Schroder FH. Interval carcinomas in the European Randomized Study of Screening for Prostate Cancer (ERSPC)-Rotterdam. J Natl Cancer Inst 2003; 95:1462-1466. PubMed
- Thompson IM, Pauler DK, Goodman PJ, et al. Prevalence of prostate cancer among men with a prostate-specific antigen level <= 4.0 ng per milliliter. N Engl J Med 2004; 350: 2239-46. New England Journal of Medicine
- Naji L, Randhawa H, Sohani Z, et al. Digital Rectal Examination for Prostate Cancer Screening in Primary Care: A Systematic Review and Meta-Analysis. Ann Fam Med 2018; 16: 149-54. pmid:29531107 PubMed
- Jønler M, Venborg Pedersen K. Diagnose, udredning og opfølgning af patienter med prostatacancer . Ugeskr Læger 2007; 169: 1889. PubMed
- Harris R, Lohr KN. Screening for prostate cancer: an update of the evidence for the U.S. Preventive Services Task Force. Ann Int Med 2002; 137: 917-29. PubMed
- Aus G, Abbou CC, Bolla M et al. EAU guidelines on prostate cancer. Eur Urol 2005; 48: 546-51. PubMed
- D'Amico AV, Chen M-H, Roehl KA, Catalona WJ. Preoperative PSA velocity and the risk of death from prostate cancer after radical prostatectomy . N Engl J Med 2004; 351: 125-35. New England Journal of Medicine
- Grönberg H, Adolfsson J, Aly M, et al. Prostate cancer screening in men aged 50-69 years (STHLM3): a prospectice population-based diagnostic study. Lancet Oncol 2015; 16: 1667-76. doi:10.1016/S1470-2045(15)00361-7 DOI
- Nicholson A, Mahon J, Boland A, et al. The clinical effectiveness and cost-effectiveness of the PROGENSA(R) prostate cancer antigen 3 assay and the Prostate Health Index in the diagnosis of prostate cancer: a systematic review and economic evaluation. Health Technol Assess. 2015. doi: 10.3310/hta19870 DOI
- Kim L, Boxall N, George A, et al. Clinical utility and cost modelling of the phi test to triage referrals into image-based diagnostic services for suspected prostate cancer: the PRIM (Phi to RefIne Mri) study. BMC Med 18, 95 (2020). doi: 10.1186/s12916-020-01548-3 DOI
- Viste E, Vinje CA, Lid TG, et al. Effects of replacing PSA with Stockholm3 for diagnosis of clinically significant prostate cancer in a healthcare system – the Stavanger experience. Scand J Prim Health Care 2020; 38: 315-22. pmid:32772613 PubMed
- Eklund M, Jäderling,F, Discacciati A, et.al. MRI-targeted or standard biopsy in prostate cancer screening. he New England Journal of Medicine (NEJM) 2021. PMID: 34237810 PubMed
- Siddiqui MM, Rais-Bahrami S, Turkbey B, Pinto PA, et al. Comparison of MR/Ultrasound fusion–guided biopsy with ultrasound-guided biopsy for the diagnosis of prostate cancer. JAMA 2015; 313: 390-7. doi:10.1001/jama.2014.17942 DOI
- Ahmed HU, Bosaily AE-S, Brown LC, et al. Diagnostic accuracy of multi-parametric MRI and TRUS biopsy in prostate cancer (PROMIS): a paired validating confirmatory study. Lancet 2017. pmid:PMID: 28110982 PubMed
- Elkhoury FF, Felker ER, Kwan L, et al. Comparison of Targeted vs Systematic Prostate Biopsy in Men Who Are Biopsy Naive The Prospective Assessment of Image Registration in the Diagnosis of Prostate Cancer (PAIREDCAP) Study. JAMA Surg 2019. pmid:31188412 PubMed
- Drost FJH, Osses DF, Nieboer D, Steyerberg EW, Bangma CH, Roobol MJ, Schoots IG. Prostate MRI, with or without MRI‐targeted biopsy, and systematic biopsy for detecting prostate cancer. Cochrane Database of Systematic Reviews 2019, Issue 4. Art. No.: CD012663. DOI: 10.1002/14651858.CD012663.pub2. DOI
- van der Leest M, Cornel E, Israël B, et al. Head-to-head Comparison of Transrectal Ultrasound-guided Prostate Biopsy Versus Multiparametric Prostate Resonance Imaging with Subsequent Magnetic Resonance-guided Biopsy in Biopsy-naïve Men with Elevated Prostate-specific Antigen: A Large Prospective Multicenter Clinical Study. Eur Urol 2019; 75: 570-8. pmid:30477981 PubMed
- Blomqvist L, Carlsson S, Gjertsson P, et al. Limited evidence for the use of imaging to detect prostate cancer: a systematic review. Eur J Radiol. 2014 Sep;83(9):1601-6. doi: 10.1016/j.ejrad.2014.06.028 DOI
- Bilddiagnostik vid stadieindelning av prostatacancer. Statens beredning för medicinsk utvärdering; Alert-rapport nr 2014-04.
- Brennhovd B. Prostatakreft. Oncolex, sist godkjent 25.10.2016. oncolex.no
- Wilt TJ, Brawer MK, Jones KM, et al. Radical prostatectomy versus obervation for localized prostate cancer. N Engl J Med 2012; 367: 203-13. New England Journal of Medicine
- James ND, Sydes MR, Mason MD, et al. Docetaxel and /pr zoledronic acid for hormone-naïve prostate cancer: First overall survival results from STAMPEDE. 2015 Asco Annual Meeting 2015. Abstract.
- Hamdy FC, Donovan JL, Lane JA. 10-Year Outcomes after Monitoring, Surgery, or Radiotherapy for Localized Prostate Cancer. N Engl J Med 2016; 375: 1415-24. pmid:27626136 PubMed
- Bill-Axelson A, Holmberg L, Garmo H, et al. Radical prostatectomy or watchful waiting in early prostate cancer. N Engl J Med 2014; 370: 932-42. DOI: 10.1056/NEJMoa1311593 DOI
- Bill-Axelson A, Holmberg L, Garmo H, et al. Radical Prostatectomy or Watchful Waiting in Prostate Cancer - 29-Year Follow-up. N Engl J Med. 2018; 379: 2319-29. PMID: 30575473 PubMed
- WiltTJ, Jones KM, Barry MJ, et al. Follow-up of prostatectomy versus observation for early prostate cancer. N Engl J Med 2017; 377: 137-42. doi:10.1056/NEJMoa1615869 DOI
- Kenfield SA, Stampfer MJ, Giovannucci E, Chan JM. Physical activity and survival after prostate cancer diagnosis in the health professionals follow-up study. J Clin Oncol 2011; 29: 726-32. PubMed
- Diaz M, Peabody JO, Kapoor V, et al. Oncologic outcomes at 10 years following robotic radical prostatectomy. European Urology, Volume 67 Issue 6, June 2015. doi:10.1016/j.eururo.2014.06.025 DOI
- Chierigo F, Wenzel M, Würnschimmel C, et al. Survival after Radical Prostatectomy versus Radiation Therapy in High-Risk and Very High-Risk Prostate Cancer. J Urol 2022; 207: 375-84. pmid:34555930 PubMed
- Jackson WC, Silva J, Hartman HE, et al. Stereotactic Body Radiation Therapy for Localized Prostate Cancer: A Systematic Review and Meta-Analysis of Over 6,000 Patients Treated On Prospective Studies. Int J Radiat Oncol Biol Phys. 2019 Jul 15;104(4):778-789. Epub 2019 Apr 6. PMID: 30959121 PubMed
- Bria E, Cuppone F, Giannarelli D, et al. Does hormone treatment added to radiotherapy improve outcome in locally advanced prostate cancer?: meta-analysis of randomized trials. Cancer 2009; 115: 3446-56. PubMed
- Dearnaley D, Hall E. How will the CHHiP trial affect the future of prostate radiotherapy?. Expert Rev Anticancer Ther 2018; 18: 607-9. pmid:29774771 PubMed
- Widmark A, Gunnlaugsson A, Beckman L, et al.. Ultra-hypofractionated versus conventionally fractionated radiotherapy for prostate cancer: 5-year outcomes of the HYPO-RT-PC randomised, non-inferiority, phase 3 trial.. Lancet 2019; 394: 385-95. pmid:31227373 PubMed
- Raabe NK, Normann M, Lilleby W. Lavdoserate brakyterapi ved lavgradig prostatakreft. Tidsskr Nor Legeforen 2015; 135: 548-52. pmid:25806763 PubMed
- Raabe NK, Lilleby W, Tafjord G, Åstrøm L. Høydoserate brakyterapi ved prostatakreft i Norge. Tidsskr Nor Legeforen 2008; 128: 1275-8. PubMed
- Kishan AU, Cook RR, Ciezki JP, et al. Radical Prostatectomy, External Beam Radiotherapy, or External Beam Radiotherapy With Brachytherapy Boost and Disease Progression and Mortality in Patients With Gleason Score 9-10 Prostate Cancer. JAMA 2018; 319: 896-905. pmid:29509865 PubMed
- Lilleby O, Hernes E, Lilleby W. Metastatic-directed therapy using PSMA-PET/CT at PSA relapse. Urol Case Rep 2019; 27: 100992. pmid:31453108 PubMed
- Wedde TB, Småstuen MC, Brabrand S, et al. Ten-year survival after High-Dose-Rate Brachytherapy combined with External Beam Radiation Therapy in high-risk prostate cancer: A comparison with the Norwegian SPCG-7 cohort. Radiother Oncol 2019; 132: 211-7. pmid:30389241 PubMed
- Lilleby W, Tafjord G, Raabe NK. Implementation of high-dose-rate brachytherapy and androgen deprivation in patients with prostate cancer. Int J Radiat Oncol Biol Phys 2012; 83: 933-9. pmid:22138456 PubMed
- Vale CL, Fisher D, Kneebone A, et al. Adjuvant or early salvage radiotherapy for the treatment of localised and locally advanced prostate cancer: a prospectively planned systematic review and meta-analysis of aggregate data. Lancet 2020. doi:10.1016/S0140-6736(20)31952-8 DOI
- Sweeney CJ, Chen YH, Carducci M et al. Chemohormonal Therapy in Metastatic Hormone-Sensitive Prostate Cancer. N Engl J Med 2015; 373: 737-46. pmid:26244877 PubMed
- Parker CC, James ND, Brawley CD et al. Radiotherapy to the primary tumour for newly diagnosed, metastatic prostate cancer (STAMPEDE): a randomised controlled phase 3 trial. Lancet 2018; 392: 2353-66. pmid:30355464 PubMed
- Ahmed HU, Hindley RG, Dickinson L, et al. Focal therapy for localised unifocal and multifocal prostate cancer: a prospective development study. Lancet Oncology 2012; : doi:10.1016/S1470-2045(12)70121-3. DOI
- Messing EM, Manola J, Sarodsy M, Wilding G, Crawford ED, Trump D. Immediate hormonal therapy compared with observation after radical prostatectomy and pelvic lymphadenectomy in men with node-positive prostate cancer. N Engl J Med 1999; 341. 1781-9.
- Fosså SD. Er alle gonadotropinanaloger likeverdige ved prostatakreft?. Tidsskr Nor Lægeforen 2005; 125: 2493-5. PubMed
- Sander S. Monoterapi med antiandrogener ved cancer prostatae. Tidsskr Nor Lægeforen 1999; 119: 1451-3. PubMed
- Chi KN, Agarwal N, Bjartell A, et al. Apalutamide for Metastatic, Castration-Sensitive Prostate Cancer. N Engl J Med 2019; 381: 13-24. pmid:31150574 PubMed
- Langley RE, Gilbert DC, Duong T, et al. Transdermal oestradiol for androgen suppression in prostate cancer: long-term cardiovascular outcomes from the randomised Prostate Adenocarcinoma Transcutaneous Hormone (PATCH) trial programme. Lancet 2021; 397: 581-91. pmid:33581820 PubMed
- Lilleby W, Hernes E, Wæhre H, Raabe N, Fosså SD. Behandling av hormonresistent prostatakreft. Tidsskr Nor Lægeforen 2006; 126: 2798-2801. PubMed
- Syversen U, Halse JI. Bisfosfonatbehandling av osteoporose og andre skjelettsykdommer. Tidsskr Nor Legeforen 2011; 131: 244-7. Tidsskrift for Den norske legeforening
- Fizazi K, Shore N, Tammela TL, et al. Darolutamide in Nonmetastatic, Castration-Resistant Prostate Cancer. N Engl J Med. 2019;380(13):1235-1246. doi:10.1056/NEJMoa1815671 DOI
- Fizazi K, Tran N, Fein L, et al. Abiraterone plus Prednisone in Metastatic, Castration-Sensitive Prostate Cancer. N EnglJ Med 2017. pmid:28578607 PubMed
- Scher HI, Fizazi K, Saad F, et al. Increased survival with enzalutamide in prostate cancer after chemotherapy. N Engl J Med 2012; 367: 1187-97. doi:10.1056/NEJMoa1207506 DOI
- Beer TM, Armstrong AJ, Rathkopf DE, et al. Enzalutamide in Metastatic Prostate Cancer before Chemotherapy. N Engl J Med 2014; 371: 424-33. doi:DOI: 10.1056/NEJMoa1405095 DOI
- Sartor O, Coleman R, Nilsson S et al. Effect of radium-223 dichloride on symptomatic skeletal events in patients with castration-resistant prostate cancer and bone metastases: results from a phase 3, double-blind, randomised trial. Lancet Oncol 2014; 15: 738. pmid:24836273 PubMed
- Wong R, Wiffen PJ. Bisphosphonates for the relief of pain secondary to bone metastases (Cochrane Review). In: The Cochrane Library, Issue 2, 2002. Update Software. The Cochrane Library
- Fizazi K, Carducci M, Smith M, et al. Denosumab versus zoledronic acid treatment of bone metastases in men with castration-resistant prostate cancer: a randomised, double-blind study. Lancet 2011; 377: 813-22. PubMed
- Thompson IM, Goodman PJ, Tangen CM, et al. The influence of finasteride on the development of prostate cancer. N Engl J Med 2003; 349: 215-24. PubMed
- Robinson D, Garmo H, Bill-Axelson A, et al. Use of 5alpha-reductase inhibitors for lower urinary tract symptoms and risk of prostate cancer in Swedish men: nationwide, population based case-control study. BMJ 2013 Jun 18;346:f3406. doi:10.1136/bmj.f3406 DOI
- Lippman SM, Klein EA, Goodman PJ, et al. Effect of selenium and vitamin E on risk of prostate cancer and other cancers. JAMA 2009; 301: 39-51. Journal of the American Medical Association
- Johansson E, Steineck G, Holmberg L, et al. Long-term quality-of-life outcomes after radical prostatectomy or watchful waiting: the Scandinavian Prostate Cancer Group-4 randomised trial. Lancet Oncol 2011; 12: 891-9. PubMed
- Smith DP, King MT, Egger S, et al. Quality of life threee years after diagnosis of localized prostate cancer: population based cohort study. BMJ 2009; 339: b4817. BMJ (DOI)
- Comiter C. Surgery for postprostatectomy incontinence: which procedure for which patient?. Nat Rev Urol. 2015; 12(2): 91-9. pmid:25558839 PubMed
- Hoffman KE, Penson DF, Zhao Z, et al. Patient-Reported Outcomes Through 5 Years for Active Surveillance, Surgery, Brachytherapy, or External Beam Radiation With or Without Androgen Deprivation Therapy for Localized Prostate Cancer. JAMA 2020; 323: 149-63. pmid:31935027 PubMed
- Anderson CA, Omar MI, Campbell SE, et al. Conservative management for postprostatectomy urinary incontinence. Cochrane Database of Syst Rev 2015; 1: CD001843. doi:10.1002/14651858.CD001843.pub5 DOI
- Potosky AL, Davis WW, Hoffman RM, et al. Five-year outcomes after prostatectomy or radiotherapy for prostate cancer: the prostate cancer outcomes study. J Natl Cancer Inst 2004; 96: 1358-67. PubMed
- Wallis CJD, Mahar AL, Choo R, et al. Second malignancies after radiotherapy for prostate cancer: systematic review and meta-analysis. BMJ 2016; 352: i851. doi:10.1136/bmj.i851 DOI
- Bagshaw HP, Arnow KD, Trickey AW et al. Assessment of Second Primary Cancer Risk Among Men Receiving Primary Radiotherapy vs Surgery for the Treatment of Prostate Cancer. JAMA Netw Open. 2022 Jul 1;5(7):e2223025. PMID: 35900763. PubMed
- Nead KT, Gaskin G, Chester C, et al. Association between androgen deprivation therapy and risk of dementia. JAMA Oncol. Published online October 13, 2016 . doi:10.1001/jamaoncol.2016.3662 DOI
- Jayadevappa R, Chhatre S, Malkowicz B, et al. Association Between Androgen Deprivation Therapy Use and Diagnosis of Dementia in Men With Prostate Cancer. JAMA Netw Open 2019; 2: e196562. pmid:31268539 PubMed
- Baik SH, Kury FSP, McDonald CJ. Risk of Alzheimer's Disease Among Senior Medicare Beneficiaries Treated With Androgen Deprivation Therapy for Prostate Cancer. J Clin Oncol. 2017. PMID: 28841388 PubMed
- Welch HG, Albertsen PC. Reconsidering Prostate Cancer Mortality — The Future of PSA Screening. N Engl J Med 2020; 382: 1557-63. doi:10.1056/NEJMms1914228 DOI
- Wolfgang Lilleby, overlege dr. med., kreftklinikken Radiumhospitalet, Oslo Universitetssykehus
- Peter D. Jost, spesialist i allmennmedisin, redaktør NEL
Tidligere fagmedarbeidere
- Truls E. Bjerklund Johansen, prof. dr. med., Urologisk afdeling, Århus Universitetshospital, 8200 Århus, DK
- Olbjørn Klepp, professor dr.med, Norges teknisk-naturvitenskapelige universitet og overlege Kreftavdelingen, St. Olavs Hospital, Trondheim
- Svein Z. Bratland, spesialist i allmennmedisin, Sandviken Legesenter, Bergen, og seniorrådgiver i Statens helsetilsyn, Oslo