Navigation Links
Predicting the return of prostate cancer: New Johns Hopkins study betters the odds of success
Date:7/2/2009

Cancer experts at Johns Hopkins say a study tracking 774 prostate cancer patients for a median of eight years has shown that a three-way combination of measurements has the best chance yet of predicting disease metastasis.

The new prediction method comprises the length of time it takes for PSA (prostate-specific antigen) to double, Gleason score (a numeric indicator of prostate cancer aggressiveness as seen under the microscope), and the interval between surgical removal of the prostate and the first detectable PSA level. According to Johns Hopkins investigators, combining these three measurements more accurately estimates risk that the cancer has spread than do other methods and should help determine which patients may benefit from additional therapy when PSA levels rise after surgery to remove the prostate.

Findings from the study presented at the June 2009 annual meeting of the American Society of Clinical Oncology (ASCO) may also help resolve the debate on when and in what form secondary treatments should occur.

"There is much debate on whether to prescribe immediate treatment for a man whose PSA begins to rise after he has had prostate cancer surgery, or to delay it," says Emmanuel Antonarakis, M.D., Johns Hopkins Kimmel Cancer Center investigator. "Studies suggest that most men live the same length of time overall whether they receive therapy at the first sign of a rising PSA or wait until the cancer has spread to other sites."

After reviewing the records of 774 men whose PSA rose after surgery to remove the prostate, the researchers found that Gleason score and two measurements for PSA were the strongest risk factors for prostate cancer metastasis. Men with Gleason scores in the highest range, between eight and 10, were twice as likely to develop metastatic cancer. In men whose PSA became detectable within three years after surgery, cancer was more than three times more likely to spread to other organs. Finally, men whose PSA doubled the fastest, within three months, were more than 20 times more likely to develop metastatic cancer than men whose PSA look longer than 15 months to double.

For men enrolled in the study, it took a median of 10 years for the disease to reappear on imaging scans. "The 10-year average will not apply to every man, so we wanted to know what factors put men at higher risk for their cancer progressing earlier," says Mario Eisenberger, M.D., professor of oncology at the Johns Hopkins Kimmel Cancer Center.

An increase in PSA, or prostate specific antigen, occurs in approximately 20 percent to 30 percent of men after surgery to remove the cancerous prostate, says Antonarakis. In these patients, the newly emerging prostate cancer cells are rarely detectable on imaging scans. When faced with the likelihood that their cancer has spread, many men opt to undergo hormone therapy, which blocks testosterone production, a fuel for prostate cancer. The side effects, which mimic those of menopausal women, include hot flashes, night sweats, osteoporosis, metabolic syndrome and coronary disease, and can be debilitating, says Antonarakis.

Besides immediate hormone therapy, other options for men whose PSA is rising are to use hormone therapy intermittently, enroll in clinical trials testing experimental therapies or combinations of them, or to "watch and wait" until imaging scans can locate metastatic disease.


'/>"/>

Contact: Amy Mone
amone1@jhmi.edu
410-955-1287
Johns Hopkins Medical Institutions
Source:Eurekalert

Related medicine news :

1. Predicting fatal fungal infections
2. Researchers determine predicting factors of positive lung cancer diagnoses in chest radiographs
3. Predicting higher risk for prostate cancer diagnosis
4. U study shows MRI-based method holds promise for predicting treatment outcomes in patients with AF
5. Systolic and diastolic blood pressures together more useful for predicting cardiovascular risk
6. Progress Made in Predicting Breast Cancer Risk
7. Researchers discover strategy for predicting the immunity of vaccines
8. Genetic Testing No Real Help in Predicting Type 2 Diabetes
9. Predicting the future for patients with severe traumatic brain injury
10. Novel imaging approach may assist in predicting success of treatment for atrial fibrillation
11. Prototype test for predicting clinical outcome for melanoma patients
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:5/24/2017)... ... 24, 2017 , ... Myers Jackson is well known for auctioning homes that ... homes anywhere on the planet. The luxury home market is alive and well and ... A quick search of “11 Spyglass Hill Auction will enlighten you on the dynamics ...
(Date:5/24/2017)... ... May 24, 2017 , ... Medic CE , a ... Truth about Pediatric Septic Shock” hosted by the Journal of Emergency Medical Services (JEMS). ... Eastern time, will be presented by Captain Rommie Duckworth, LP, a career fire captain ...
(Date:5/24/2017)... ... 24, 2017 , ... Adelberg-Montalvan Pediatric Dentistry and Orthodontics ... patients on Long Island, New York. , Holistic dentistry puts dental health ... of the biggest trends in dentistry today. , Dentist Dr. Marc Adelberg ...
(Date:5/24/2017)... ... 24, 2017 , ... Fiberstar, Inc., http://www.FiberstarIngredients.com a ... beverage industry offers Citri-Fi®, a natural citrus fiber, to improve beverage ingredient declarations. ... a result, labels need to deliver simple, transparent and clear messaging. Listed food ...
(Date:5/23/2017)... ... May 23, 2017 , ... MDLand International (MDLand), a ... today that its iClinic V12.2 solution has achieved approval from National Center for ... PCMH 2017 standards which emphasize team-based care with a significant focus on the ...
Breaking Medicine News(10 mins):
(Date:5/6/2017)... , May 5, 2017  May is Stroke Awareness ... of the most important methods to prevent a stroke: ... Centers for Disease Control and Prevention, undetected and uncontrolled ... Omron, the global leader in personal heart health ... elimination of heart attack and stroke and is advancing ...
(Date:5/4/2017)... May 4, 2017 Clarius Mobile Health, ... handheld ultrasound scanners this week at the American ... (ACOG) in San Diego, CA ... "Clarius is the perfect tool for clinicians to ... rate, and evaluate pregnancy-related complications like ectopic pregnancy ...
(Date:5/4/2017)... 4, 2017   BioLife Solutions , Inc. (NASDAQ: ... marketer of proprietary clinical grade hypothermic storage ... "Company"), today announced that the Company,s first quarter 2017 ... Thursday, May 11, 2017, and that the Company will ... p.m. PT that afternoon. Management will provide an overview ...
Breaking Medicine Technology: