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Study: Why Some Prostate Cancer Returns
May 28, 2009ORLANDO - The majority of men who receive one of the standard treatments for localized prostate cancer - surgery or radiation therapy - have an excellent outcome.
But for the small group whose prostate cancer returns, a new study offers insight as to why treatment isn't effective.
The study - a collaboration between researchers at the Josephine Ford Cancer Center at Henry Ford Hospital and Fox Chase Cancer Center - shows that men with a low oxygen supply to their tumor have a higher chance of the prostate cancer returning, as found by increasing prostate-specific antigen (PSA) levels following treatment.
"After several years of research, we were able to show that low levels of oxygen to the tumor are highly related to a patient's outcome. Those with lower oxygen levels to the prostate cancer did not respond as well to radiation therapy, and the cancer returned more often," says Benjamin Movsas, M.D., senior study author and chair of the Department of Radiation Oncology at Henry Ford Hospital. Moreover, recent studies suggest the same finding also appears to apply to patients treated with surgery.
Results from the study will be presented May 31 at the American Society of Clinical Oncology (ASCO) annual meeting in Orlando.
Prostate cancer affects one in six men in the United States, but according to the American Cancer Society only one in 35 will die of it. The majority of all prostate cancer are diagnosed in men older than 65.
According to Dr. Movsas, oxygen being delivered to a tumor is critical to the treatment for many cancers. Radiation therapy, for example, creates free radicals that damage DNA in tumors, and oxygen acts as the mediator that perpetuates the free radicals.
That's why Dr. Movsas began his work nearly a decade ago to investigate low oxygen levels - also known as tumor hypoxia - in prostate cancer tumors while working at Fox Chase.
To measure the amount of oxygen being delivered to the tumors and surrounding areas, Dr. Movsas and his colleagues at Fox Chase used custom-made oxygen probes to test 57 patients with low or immediate risk of cancer prior to radiation therapy. The probe was used prior to "radioactive seeds" which were implanted in the prostate.
Dr. Movsas' initial research found that it is possible for prostate cancer tumors to have low oxygen levels. The next step was for the team to track the long-term correlation between low oxygen levels and PSA levels following treatment.
These new findings, being presented at ASCO, ultimately reveal that a tumor's oxygen supply can significantly predict a patient's outcome following treatment, independent from tumor stage or Gleason score, a classification of the grade of prostate cancer. Of the 57 patients, the study found that eight experienced an increase in their PSA levels about eight years following treatment.
"By identifying patients at risk with low oxygen levels in prostate tumors, we're now able to build on this research and begin to explore novel treatment options for this small subset of patients. It's possible we'll find that these patients will do best with a combination of radiation therapy and other novel approaches, such as angiogenesis therapy (targeting blood vessels) or possibly even gene therapy. That's where our research is taking us next," says Dr. Movsas. "Non-invasive methods to detect oxygen levels in tumors are also very important."
Reference: "Hypoxic Prostate/Muscle pO2 (P/M pO2) Ratio Predicts for Biochemical Failure in Patients with Localized Prostate Cancer: Long-term Result." Abstract # 5136. ASCO 2009.
Henry Ford Health System
"After several years of research, we were able to show that low levels of oxygen to the tumor are highly related to a patient's outcome. Those with lower oxygen levels to the prostate cancer did not respond as well to radiation therapy, and the cancer returned more often," says Benjamin Movsas, M.D., senior study author and chair of the Department of Radiation Oncology at Henry Ford Hospital. Moreover, recent studies suggest the same finding also appears to apply to patients treated with surgery.
Results from the study will be presented May 31 at the American Society of Clinical Oncology (ASCO) annual meeting in Orlando.
Prostate cancer affects one in six men in the United States, but according to the American Cancer Society only one in 35 will die of it. The majority of all prostate cancer are diagnosed in men older than 65.
According to Dr. Movsas, oxygen being delivered to a tumor is critical to the treatment for many cancers. Radiation therapy, for example, creates free radicals that damage DNA in tumors, and oxygen acts as the mediator that perpetuates the free radicals.
That's why Dr. Movsas began his work nearly a decade ago to investigate low oxygen levels - also known as tumor hypoxia - in prostate cancer tumors while working at Fox Chase.
To measure the amount of oxygen being delivered to the tumors and surrounding areas, Dr. Movsas and his colleagues at Fox Chase used custom-made oxygen probes to test 57 patients with low or immediate risk of cancer prior to radiation therapy. The probe was used prior to "radioactive seeds" which were implanted in the prostate.
Dr. Movsas' initial research found that it is possible for prostate cancer tumors to have low oxygen levels. The next step was for the team to track the long-term correlation between low oxygen levels and PSA levels following treatment.
These new findings, being presented at ASCO, ultimately reveal that a tumor's oxygen supply can significantly predict a patient's outcome following treatment, independent from tumor stage or Gleason score, a classification of the grade of prostate cancer. Of the 57 patients, the study found that eight experienced an increase in their PSA levels about eight years following treatment.
"By identifying patients at risk with low oxygen levels in prostate tumors, we're now able to build on this research and begin to explore novel treatment options for this small subset of patients. It's possible we'll find that these patients will do best with a combination of radiation therapy and other novel approaches, such as angiogenesis therapy (targeting blood vessels) or possibly even gene therapy. That's where our research is taking us next," says Dr. Movsas. "Non-invasive methods to detect oxygen levels in tumors are also very important."
Reference: "Hypoxic Prostate/Muscle pO2 (P/M pO2) Ratio Predicts for Biochemical Failure in Patients with Localized Prostate Cancer: Long-term Result." Abstract # 5136. ASCO 2009.
Henry Ford Health System
Prostate Cancer Current Events and Prostate Cancer News RSSDoes prostate-specific antigen velocity help in early detection prostate cancer?
The November issue of European Urology, the official journal of the European Association of Urology, features an article focussing on prostate specific antigen (PSA) velocity and early cancer detection. It has been suggested that changes in PSA over time aid prostate cancer detection.
New Synthetic Molecules Trigger Immune Response to HIV and Prostate Cancer
Researchers at Yale University have developed synthetic molecules capable of enhancing the body's immune response to HIV and HIV-infected cells, as well as to prostate cancer cells. Their findings, published online in the Journal of the American Chemical Society, could lead to novel therapeutic approaches for these diseases.
Chemo-radiation before prostate removal may prevent cancer recurrence
Researchers in the Oregon Health & Science University Knight Cancer Institute and the Portland Veterans Affairs Medical Center have found a combination of radiation therapy and chemotherapy given before prostate removal is safe and may have the potential to reduce cancer recurrence and improve patient survival.
Blood vessels might predict prostate cancer behavior
A diagnosis of prostate cancer raises the question for patients and their physicians as to how the tumor will behave. Will it grow quickly and aggressively and require continuous treatment, or slowly, allowing therapy and its risks to be safely delayed?
Short-term hormone therapy and intermediate dose radiation increases survivial for early stage prostate cancer
Short-term hormone therapy given prior to and during intermediate dose radiation treatment for men with early stage prostate cancer increases their chance of living longer, compared to those who receive the same radiation alone.
Task force develops new radiation guidelines for brachytherapy
Radiation dose delivered to the prostate and nearby organs in every brachytherapy procedure should be carefully analyzed using post-implant CT or MRI and uniformly documented in every patient.
1 disease, not 1 demographic
The Asian continent has nearly four billion people living in 47 different countries, and each of these groups has their own unique set of health issues. But when they come to the United States, they're often lumped into one large demographic: "Asian/Pacific Islander."
Cancer survivors may not be getting the help they need to stop smoking
More than a quarter of cancer survivors who still smoke have not been advised to quit smoking by their health care providers in the last year, according to a study published by researchers at Fox Chase Cancer Center in the current issue of the Journal of General Internal Medicine.
Experts issue call to reconsider screening for breast cancer and prostate cancer
Twenty years of screening for breast and prostate cancer - the most diagnosed cancer for women and men - have not brought the anticipated decline in deaths from these diseases, argue experts from the University of California, San Francisco and the University of Texas Health Science Center at San Antonio in an opinion piece published in the "Journal of the American Medical Association."
Detecting the undetectable in prostate cancer screening
A team of Northwestern University researchers, using an extremely sensitive tool based on nanotechnology, has detected previously undetectable levels of prostate-specific antigen (PSA) in patients who have undergone radical prostatectomy.
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