PSA is poor predictor of lethal prostate cancer

April 03, 2007

The amount of prostate-specific antigen (PSA) in a man's bloodstream at the time of his prostate cancer diagnosis or its rate of change over the course of the disease does not adequately predict lethal prostate cancer, according to a study in the April 4 Journal of the National Cancer Institute.

Although men with untreated localized prostate cancer have high long-term survival rates, many patients undergo treatment anyway. In order to avoid unnecessary treatment, researchers want to identify methods to determine which patients will develop lethal prostate cancer. The rate of increase of PSA--a protein produced by the prostate--before prostate cancer treatment has been associated with the patient's prognosis, which suggests that early measurements of PSA may predict the behavior of the tumor.

To assess the accuracy of using PSA to predict prostate cancer outcome, Katja Fall, M.D., Ph.D., of the Karolinska Institute in Stockholm, and colleagues analyzed the rate of change of PSA levels in 267 men from Sweden, Finland, and Iceland who were diagnosed with early localized prostate cancer between 1989 and 1999. The researchers recorded the PSA levels for the first two years after diagnosis to capture the patients' early PSA patterns. The men in the study received no curative treatment for the first two years but were closely watched for signs of progression, which is called watchful waiting.

At the end of the follow-up in December 2003, 34 patients had died from prostate cancer, and 18 had developed metastatic prostate cancer but were still alive. Although initial PSA values and the rate of change were associated with later development of lethal prostate cancer, they were not accurate enough to predict lethal cancer.

"We conclude that PSA measurement is associated with prostate cancer prognosis and continues to be an important monitoring tool," the authors write. "However, early PSA characteristics perform poorly in distinguishing those who develop a lethal prostate cancer from those at low or no risk of disease progression. Therefore, better decision tools are needed for active monitoring of patients with early disease."

In an accompanying editorial, Dipen Parekh, M.D., of the University of Texas Health Science Center at San Antonio, and colleagues compared the results of this new study with their own work and found consistent results regarding PSA, as well as other measures that were related to prostate cancer risk. "These data demand that clinical trials commence now to examine surveillance strategies to help patients and their physicians identify and treat tumors that will otherwise be life threatening and to carefully follow those that will not. Our limited health care resources and the quality of life of an enormous number of men will benefit from this for decades to come," the authors write.
-end-
EMBARGOED FOR RELEASE: 3 APRIL 16:00 EST

Contact:Citation:Note: The Journal of the National Cancer Institute is published by Oxford University Press and is not affiliated with the National Cancer Institute. Attribution to the Journal of the National Cancer Institute is requested in all news coverage. Visit the Journal online at http://jnci.oxfordjournals.org/.

Journal of the National Cancer Institute

Related Prostate Cancer Articles from Brightsurf:

Low risk of cancer spread on active surveillance for early prostate cancer
Men undergoing active surveillance for prostate cancer have very low rates - one percent or less - of cancer spread (metastases) or death from prostate cancer, according to a recent study published in the Journal of Urology®, an Official Journal of the American Urological Association (AUA).

ESMO 2020: Breast cancer drug set to transform prostate cancer treatment
A drug used to treat breast and ovarian cancer can extend the lives of some men with prostate cancer and should become a new standard treatment for the disease, concludes a major trial which is set to change clinical practice.

Major trial shows breast cancer drug can hit prostate cancer Achilles heel
A drug already licensed for the treatment of breast and ovarian cancers is more effective than targeted hormone therapy at keeping cancer in check in some men with advanced prostate cancer, a major clinical trial reports.

The Lancet: Prostate cancer study finds molecular imaging could transform management of patients with aggressive cancer
Results from a randomised controlled trial involving 300 prostate cancer patients find that a molecular imaging technique is more accurate than conventional medical imaging and recommends the scans be introduced into routine clinical practice.

Common genetic defect in prostate cancer inspires path to new anti-cancer drugs
Researchers found that, in prostate cancer, a mutation leading to the loss of one allele of a tumor suppressor gene known as PPP2R2A is enough to worsen a tumor caused by other mutations.

First prostate cancer therapy to target genes delays cancer progression
For the first time, prostate cancer has been treated based on the genetic makeup of the cancer, resulting in delayed disease progression, delayed time to pain progression, and potentially extending lives in patients with advanced, metastatic prostate cancer, reports a large phase 3 trial.

Men taking medications for enlarged prostate face delays in prostate cancer diagnosis
University of California San Diego School of Medicine researchers report that men treated with medications for benign prostatic hyperplasia (enlarged prostate) experienced a two-year delay in diagnosis of their prostate cancer and were twice as likely to have advanced disease upon diagnosis.

CNIO researchers confirm links between aggressive prostate cancer and hereditary breast cancer
The study has potential implications for families with members suffering from these types of tumours who are at an increased risk of developing cancer.

Distinguishing fatal prostate cancer from 'manageable' cancer now possible
Scientists at the University of York have found a way of distinguishing between fatal prostate cancer and manageable cancer, which could reduce unnecessary surgeries and radiotherapy.

Researchers find prostate cancer drug byproduct can fuel cancer cells
A genetic anomaly in certain men with prostate cancer may impact their response to common drugs used to treat the disease, according to new research at Cleveland Clinic.

Read More: Prostate Cancer News and Prostate Cancer Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.