Prostate cancer (CaP) refers to a common malignant tumor of glandular origin arising in the prostate gland. It occurs in three forms according to the family history: sporadic, familial, hereditary. Familial CaP is usually defined as the clustering of at least 2 first- or second-degree relatives with CaP within a family. Hereditary Prostate cancer is a subset of the familial forms and is usually defined as the familial clustering of at least 3 first-degree relatives with the disease, or two relatives diagnosed below the age of 55 years. These criteria must be extended to second-degree relatives on the maternal side in order to include X-linked transmission of the disease. Familial and hereditary CaP account for 20% and 5% of prostate cancers, respectively. The age at diagnosis in familial forms is 5 to 10 years earlier than in sporadic forms, suggesting an early onset screening from the age of 45 years for all men with a family history of prostate cancer. Diagnosis of prostate cancer is based on prostate biopsy, which is indicated on suspicious biological (increased blood levels of Prostate Specific Antigen (PSA)) or clinical signs (induration of the prostate) of prostate cancer. Hereditary or familial prostate cancer do not require specific therapy and have not shown better or worse prognosis than sporadic prostate cancer with equivalent stage and grade of the disease at diagnosis. Treatment of organ-confined prostate cancer is based on surgical prostatectomy or radiotherapy. Treatment of loco-regional advanced disease or metastatic disease consists of androgen withdrawal. Chemotherapy and other palliative treatment are used during uncontrolled progression of the disease under hormonal treatment.
Last update: March 2003