RT Book, Section A1 Scher, Howard I. A1 Eastham, James A. A2 Kasper, Dennis A2 Fauci, Anthony A2 Hauser, Stephen A2 Longo, Dan A2 Jameson, J. Larry A2 Loscalzo, Joseph SR Print(0) ID 1120792942 T1 Benign and Malignant Diseases of the Prostate T2 Harrison's Principles of Internal Medicine, 19e YR 2014 FD 2014 PB McGraw-Hill Education PP New York, NY SN 9780071802154 LK accesspharmacy.mhmedical.com/content.aspx?aid=1120792942 RD 2022/06/26 AB Benign and malignant changes in the prostate increase with age. Autopsies of men in the eighth decade of life show hyperplastic changes in >90% and malignant changes in >70% of individuals. The high prevalence of these diseases among the elderly, who often have competing causes of morbidity and mortality, mandates a risk-adapted approach to diagnosis and treatment. This can be achieved by considering these diseases as a series of states. Each state represents a distinct clinical milestone for which therapy(ies) may be recommended based on current symptoms, the risk of developing symptoms, or death from disease in relation to death from other causes within a given time frame. For benign proliferative disorders, symptoms of urinary frequency, infection, and potential for obstruction are weighed against the side effects and complications of medical or surgical intervention. For prostate malignancies, the risks of developing the disease, symptoms, or death from cancer are balanced against the morbidities of the recommended treatments and preexisting comorbidities.