Dilemmas in managing prostate carcinoma (Part I): Localized disease

Since we cannot predict which patients have biologically significant prostatic carcinoma, except in the face of other known, significantly life-limiting disease, all palpable abnormalities should be considered for a diagnostic procedure. Negative core needle biopsy, fine needle aspiration, open perineal biopsy, transurethral biopsy, or urinary and prostatic fluid cytology results do not exclude cancer. If cancer is suspected, repeat biopsies and careful, frequent follow-up are mandatory.