Prostate Cancer: An update on the recent advances in the diagnosis and management with special reference to Saudi Arabia

In recent years, there has been a major change in the presentation of the Cancer of the Prostate gland (CaP) in the industrially developed countries. Currently, in those countries CaP patients present in a new early preclinical stage designated only recently in 1992 as stage T1c. The two main factors behind this change are: the advent of Prostatic Specific Antigen (PSA) and the increased prosperity with the associated prolonged longevity. Currently, PSA is recognised as the most sensitive tumor marker widely used for CaP initial screening and for tumor monitoring. The other factor yielded to the recently noted rise the annual prevalence rates of CaP is that the male population nowadays live to ages at which the incidence of CaP peaks.Over the past two decades, CaP has been the most frequently diagnosed cancer in the American and the second most common in European men. The rates are progressively increasing. But this is not the case for eastern countries so far, especially in Saudi Arabia. On the contrary, this article will show that this cancer is still not frequently diagnosed in Saudi Arabia, a great opportunity for us to study its natural history and plan for preventive measures. Stage T1c of the prostate is a pre-clinical biopsy diagnosed cancer based upon PSA-screening. The only part of Saudi Arabia where patients commonly present in this stage is the industrially advanced ARAMCO community. In that community only, not in the whole Eastern province, dwelling elderly men are regularly screened annually by PSA testing for prostate cancer. Most of the CaP patients in the rest of Saudi Arabia present at the other later stages of the disease.