Book Review

Prostate Cancer: Signaling Networks, Genetics, and New Treatment Strategies

N Engl J Med 2008; 359:772August 14, 2008

Article

Prostate Cancer: Signaling Networks, Genetics, and New Treatment Strategies
(Current Clinical Oncology.) Edited by Richard G. Pestell and Marja T. Nevalainen. 455 pp., illustrated. Totowa, NJ, Humana Press, 2008. $139 (cloth); $99 (paper). ISBN: 978-1-58829-741-9 (cloth); 978-1-60327-518-7 (paper).

More than 218,000 new cases of prostate cancer are diagnosed every year in the United States. Great improvements in diagnosis and treatment have been made over the past two decades, but because prostate cancer has marked variability in its rate of progression, it remains a challenge for researchers attempting to unravel its heterogeneous character.

In this detailed and up-to-date book, leaders in prostate cancer research review the current knowledge of genetic pathways and major molecular aberrations involved in prostate cancer as well as the treatment of the disease. The literature is thoroughly reviewed — some chapters contain more than 200 references — and the editors have succeeded in keeping the text to the point and easy to read. The figures and tables are clear and provide essential additional information.

The first part of the book focuses on key genetic changes in prostate cancer and the role of the nuclear hormone receptors. The well-established role of the androgen receptor in the onset, progression, and treatment of prostate cancer is extensively reviewed. Many issues regarding androgen-receptor function are still under investigation, but the number of chapters in the book that address this topic seems excessive when compared with the number of chapters covering other important genetic alterations in prostate cancer, such as the recently identified gene fusions and other intracellular signaling pathways.

The second part of the book highlights recent improvements in the treatment of prostate cancer. Surgery, radiotherapy, hormonal therapy, chemotherapy, and targeted therapy are evaluated. One might question why chapters on radical prostatectomy and radiotherapy are included in a book whose main focus is the molecular aspect of the disease, but these chapters are excellent examples of how translational research has led to novel therapies for malignant disease. The detailed molecular knowledge described in the first section of the book forms a solid base from which these treatments can be critically evaluated. Future perspectives and opportunities to target other molecular sites in prostate cancer are mentioned in the final chapter.

The role of screening and active surveillance for prostate cancer is not extensively discussed. As a result of prostate-specific antigen screening, a large number of men are diagnosed with a tumor that would never have been evident clinically during their lifetime. An additional chapter on the most promising biomarkers that could solve the prostate cancer dilemma — to treat or not to treat — would have been valuable. Still, the editors and authors have succeeded in clearly summarizing the most important recent advances in prostate cancer research, and the book will interest urologists, medical oncologists, and prostate cancer researchers.

Joost L. Boormans, M.D.
Erasmus Medical Center, 3000 CA Rotterdam, the Netherlands
j.boormans@erasmusmc.nl