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Doctors can now detect hard-to-diagnose prostate cancer
Date:8/8/2012

en) test alone is not a good indicator of prostate cancer. "It measures multiple factors associated with prostate disease, including enlargement of the prostate and inflammation."

The research team decided to see what would happen to PSA levels after the use of two 5-alpha-reductase inhibitor drugs -- finasteride and dutasteride -- designed to reduce the size of an enlarged prostate. The theory is that these drugs might improve the usefulness of PSA in diagnosing prostate cancer. If the PSA remains persistently high even though the prostate has shrunk, or PSA rises after having reached its lowest level, it could indicate the presence of cancer. And when the gland is smaller, a biopsy can be more effective, according to researchers.

The study was conducted in two phases. It enrolled 276 men at NewYork-Presbyterian/Weill Cornell whose PSA was greater than 4, who had a normal digital rectal examination and two or more negative biopsies.

In the first phase, 97 patients, who were given 5 milligrams of finasteride or 0.5 milligrams of dutasteride daily, had their PSA measured at 6 and 12 months, a transrectal ultrasonography and a biopsy performed at 1 year. Study results show that a year of the drug therapy reduced PSA in all the men -- an average of 48 percent -- but the magnitude of reduction was significantly greater in men with benign prostate disease and significantly less in 28 percent of the patients whose prostate biopsy detected cancer.

In the second phase of the study, 179 patients received the same drug therapy but underwent a biopsy only if their PSA showed a change of 0.4 ng/dl. In all, 42 men (27 percent) had the biopsy, and 26 of those participants (54 percent) had cancer. Within that group, 77 percent of the patients had high-grade tumors.

Researchers successfully identified cancer cases in men who participated in the second phase study with the combined drug therapy and evaluation of PSA trends, by sending thos
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Contact: Takla Boujaoude
tab2016@med.cornell.edu
212-821-0560
New York- Presbyterian Hospital/Weill Cornell Medical Center/Weill Cornell Medical College
Source:Eurekalert

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