National XXXX Network guidelines for the management of @entity263 .

@entity1 @entity263 @entity5 @entity342 @entity1486
Guidelines for the management of @entity263 issued by the National @entity5 Network provide a basis for rational treatment decisions. These guidelines represent consensus recommendations by a panel of experts that are evidence based and are designated according to the degree of consensus within the expert panel. The initial stratification point is the @entity1 's life expectancy (>5 or <5 years). If life expectancy is >5 years, the recommended intervention is based on clinical stage, @entity1486 level, and Gleason score, as well as the presence of symptoms. These assessments establish the @entity1 's risk of recurrence after therapy. Specific initial therapies are then recommended according to whether the risk category is low, intermediate, high, or very high. The guidelines also describe the appropriate use of observation ("watchful waiting") versus active intervention in certain @entity1 . After definitive therapy, @entity1 should be monitored with @entity1486 determinations, digital rectal examination, and bone scans, as outlined in the guidelines. @entity1 who exhibit increasing @entity1486 levels after prostatectomy are candidates for salvage therapy with @entity342 ablation, radiotherapy, or observation. If @entity1486 levels begin to increase after radiotherapy, surgery may then be an additional option. Systemic salvage therapy generally consists of @entity342 ablation; the benefit of total @entity342 blockade versus initial monotherapy remains controversial. Relapse after initial @entity342 ablation is treated with an antiandrogen, if none had been administered previously. @entity1 refractory to further hormonal manipulations are observed or receive palliative therapy, including chemotherapy. The treatment of @entity263 is complex. Optimal treatment is risk-adapted to the specific characteristics of the @entity5 and the expected longevity and personal preferences of the @entity1 .
