se appeared to be caught earlier in exposed veterans. Most had their disease staged as T1 by pathologists, which means it appeared confined to the prostate gland, and had lower pre-operative prostate specific antigen scores, an indicator of disease aggressiveness.
However, when the disease recurred, exposed veterans experienced a more rapid biochemical progression of their disease, which PSA measures. In blacks, the PSA doubled in almost half the time of their unexposed peers.
A blood PSA level screens for prostate cancer for most men beginning at age 50 and at age 40 for blacks and men with a family history. Black men have been shown by Dr. Terris and others to have more aggressive disease earlier in life.
To account for known racial differences, researchers also compared recurrence rates in exposed and non-exposed blacks and whites and the results held up.
"As a population in general, if you were exposed to Agent Orange, youre more likely to have a recurrence," says Dr. Shah. "If you were black and exposed, you were more likely to recur than if you were black and unexposed."
If it sounds odd that men who had their prostate removed could have disease recurrence, Dr. Terris points out that microscopic cancer cells can migrate out of the area before surgery, becoming detectable later when they start pushing PSA levels back up.
In fact, following any type of prostate cancer treatment, men routinely get PSA levels checked for the rest of their lives. Without cancer recurrence, they should stay at zero.
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