[Prostatic cancer--what to do?].

Therapeutic considerations for prostatic cancer are determined by the stage and the differentiation of the tumor and by the patient's age. Local treatment (radical prostatovesiculectomy, external or interstitial irradiation) is reserved for T1-T2 N0 M0 tumors. The best cure rate in these tumor stages achieves the radical prostatectomy, which is indicated up to the 70th year of life, provided a good general condition. Impotentia after radical prostatectomy appears in almost 100% while urinary incontinence occurs in about 5%. External or interstitial irradiation can also be used in stage T1-T3 N0 M0, if radical surgery is not possible. The 5- and 10-year survival rate after high voltage or interstitial radiation therapy for stage T1-T2 reaches up to 75% and 47%, respectively, while for stage T3 the survival rate lies between 50% after 5 years and 30% after 10 years. Prostatic cancer proceeding across the border line of the prostate or metastasizing tumors can be treated by systemic therapy modalities. The contrasexual therapy (orchiectomy with or without estrogens) and the employment of antiandrogens are palliative methods. The efficacy of these therapy modalities depends on the hormone receptors in the neoplastic tissue, although these receptors are difficult to prove until now. Cytostatics are used in hormone resistant tumors, but the success rate is rather low. Adjuvant procedures (hypophysectomy and bilateral adrenalectomy) are of no importance anymore. Hyperprolactinemia is an indication for bromocriptine, and cortisone can reduce pain by reduction of perimetastatic edemas.(ABSTRACT TRUNCATED AT 250 WORDS)