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Prostate cancer

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  • Descripción general
  • Teoría
  • Diagnóstico
  • Manejo
  • Seguimiento
  • Recursos
Última revisión: 2 Dec 2025
Última actualización: 12 May 2025

Resumen

Definición

Anamnesis y examen

Principales factores de diagnóstico

  • elevated prostate-specific antigen (PSA)
Todos los datos

Otros factores de diagnóstico

  • abnormal digital rectal exam (DRE)
  • nocturia
  • urinary frequency
  • urinary hesitancy
  • dysuria
  • hematuria
  • weight loss/anorexia
  • lethargy
  • bone pain
  • palpable lymph nodes
Todos los datos

Factores de riesgo

  • age >50 years
  • black ethnicity
  • Northern European, Caribbean, Australian, New Zealand, North American, and Southern African populations
  • positive family history/genetic factors
  • high levels of dietary fat
Todos los datos

Pruebas diagnósticas

Primeras pruebas diagnósticas para solicitar

  • serum prostate-specific antigen (PSA)
  • prebiopsy multiparametric MRI
  • prostate biopsy
Todos los datos

Pruebas diagnósticas que deben considerarse

  • prebiopsy biomarker tests and risk calculators
  • testosterone
  • LFTs
  • CBC
  • renal function
  • bone scan (technetium-99)
  • CT scan
  • MRI
  • prostate-specific membrane antigen (PSMA)-PET/CT
  • PSMA-PET/MRI
  • tumor molecular and genetic testing
  • genetic evaluation and germline testing
Todos los datos

Algoritmo de tratamiento

Agudo

very low-risk disease

low-risk disease

favorable intermediate-risk disease

unfavorable intermediate-risk disease

high-risk or very high-risk disease

En curso

nonmetastatic disease: postradical prostatectomy

nonmetastatic disease: postradiation therapy

nonmetastatic disease: castration-resistant

metastatic disease: castration-sensitive

metastatic disease: castration-resistant

Colaboradores

Autores

Timothy J. Wallace, MD, PhD

Radiation Oncologist

Department of Radiation Oncology

Virginia Commonwealth University

Richmond

VA

Divulgaciones

TJW declares that he has no competing interests.

Mitchell S. Anscher, MD, FACR, FACRO, FASTRO

Professor Emeritus

Department of Radiation Oncology

Virginia Commonwealth University

Richmond

VA

Divulgaciones

MSA declares that he has no competing interests.

Revisores por pares

Emma Alexander, MBBS

Clinical Oncology Registrar

St Luke's Cancer Centre

Royal Surrey Hospital

Guildford

Surrey

UK

Divulgaciones

EA has received consultation fees from the following organizations: Blue Cross/Blue Shield Association, Sanofi-Aventis, Ferring Pharmaceuticals, Pfizer Corporation, American Urological Association, National Institutes of Health, Accreditation Council for Graduate Medical Education, Royal Hallamshire Hospital, Hartford County Medical Association. EA owns shares in Pfizer Pharmaceuticals, Johnson and Johnson, and General Electric Corporation.

Peter Albertsen, MD

Medical Director

UConn Medical Group

University of Connecticut Health Center

Farmington

CT

Divulgaciones

PA declares that he has no competing interests.

Patrick C. Walsh, MD

University Distinguished Service Professor of Urology

Professor Emeritus of Urology

Brady Urological Institute

Johns Hopkins University

Baltimore

MD

Divulgaciones

PCW declares that he has no competing interests.

James Kearns, MD

Assistant Professor of Urology

NorthShore University HealthSystem

Chicago

IL

Divulgaciones

JK declares that he has no competing interests. JK is an author of an article cited in the topic.

Agradecimiento de los revisores por pares

Los temas de BMJ Best Practice se actualizan de forma continua de acuerdo con los desarrollos en la evidencia y en las guías. Los revisores por pares listados aquí han revisado el contenido al menos una vez durante la historia del tema.

Divulgaciones

Las afiliaciones y divulgaciones de los revisores por pares se refieren al momento de la revisión.

Referencias

Nuestros equipos internos de evidencia y editoriales colaboran con colaboradores expertos internacionales y revisores pares para garantizar que brindemos acceso a la información más clínicamente relevante posible.

Artículos principales

National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology: prostate cancer [internet publication].Texto completo

National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology: prostate cancer early detection [internet publication].Texto completo

Parker C, Castro E, Fizazi K, et al. Prostate cancer: ESMO clinical practice guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2020 Sep;31(9):1119-34.Texto completo  Resumen

Morgan SC, Hoffman K, Loblaw DA, et al. Hypofractionated radiation therapy for localized prostate cancer: an ASTRO, ASCO, and AUA evidence-based guideline. J Clin Oncol. 2018 Oct 11;36(34):JCO1801097.Texto completo  Resumen

Morgan TM, Boorjian SA, Buyyounouski MK, et al. Salvage therapy for prostate cancer: AUA/ASTRO/SUO guideline part I: introduction and treatment decision-making at the time of suspected biochemical recurrence after radical prostatectomy. J Urol. 2024 Apr;211(4):509-17.Texto completo  Resumen

Morgan TM, Boorjian SA, Buyyounouski MK, et al. Salvage therapy for prostate cancer: AUA/ASTRO/SUO guideline part II: treatment delivery for non-metastatic biochemical recurrence after primary radical prostatectomy. J Urol. 2024 Apr;211(4):518-25.Texto completo  Resumen

Morgan TM, Boorjian SA, Buyyounouski MK, et al. Salvage therapy for prostate cancer: AUA/ASTRO/SUO guideline part III: salvage therapy after radiotherapy or focal therapy, pelvic nodal recurrence and oligometastasis, and future directions. J Urol. 2024 Apr;211(4):526-32.Texto completo  Resumen

Artículos de referencia

Una lista completa de las fuentes a las que se hace referencia en este tema está disponible para los usuarios con acceso a todo BMJ Best Practice.

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