Many novel techniques for the treatment of prostate cancer are being aggressively investigated for two reasons: (1) prostate cancer is prevalent in the population, and (2) the current treatments for advanced prostate cancer are woefully inadequate. Antiangiogenesis has great potential as stand-alone therapy to transform prostate cancer into a chronic disease or, in combination with the available therapies, to provide curative approaches with decreased treatment-related morbidities. Further understanding of the angiogenic cascade will reveal additional molecular targets and advancements in molecular delivery approaches, such as gene therapy, will lead to the development of safe and effective treatment strategies. There are many complex interactions between the immune system and prostate cancer. Although our understanding of these interactions is improving, further understanding will lead to novel treatment strategies. These include the idea that manipulation of cellular pathways, such as the work with growth factor receptors, can lead to tumor stabilization and eventually cytoreduction with continued cell turnover. The adjuvant use of immunotherapy for prostate cancer could also help increase efficacy of current oncologic treatments. This may be even more significant when used in conjuction with nomograms that may predict men who are at particularly high risk for failure of local treatment, and who would be better served with adjuvent immune therapy. The safety and efficacy of gene therapy for prostate cancer has been demonstrated through various preclinical and clinical trials, and potentially holds the greatest promise. In recent years, interest in this field has expanded and will continue to do so. Because it is conveniently administered through ultrasound-guided transrectal injection, it is also conceivable that gene therapy applied in an outpatient clinic may someday replace current therapy to treat early prostate cancer. As a therapy, it is the culmination of the work of many disciplines that will result in an elegant targeted, efficient, and versatile strategy against prostate cancer. It is conceivable that, in the near future, any of these experimental modalities will be developed to replace hormone ablation therapy which causes unpleasant side effects, decreases the quality of life of the patient, and only temporarily controls the disease. Factors that limit the disseminated use of these advanced therapies as standards of care include time, funding, and fear from the general public; however, these should diminish as the number of successful clinical trials increase.
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