Time between treatment and PSA recurrence predicts death from prostate cancer
Men whose prostate specific antigen (PSA) rise within 18 months of radiotherapy are more likely to develop spread and die of their disease, according to an international study led by Fox Chase Cancer Center radiation oncologist Mark K. Buyyounouski, M.D., M.S. and presented today at the annual meeting of the American Society for Radiation Oncology (ASTRO). "PSA is the gold standard for following prostate cancer patients after they receive radiation or surgery. But we haven't know if having PSA rise sooner means a patient has a greater danger of dying of prostate cancer, though it seems logical," Buyyounouski says.
Using a single institution database, Buyyounouski and colleagues showed previously that men who suffered an early biochemical failure, which is defined as their lowest PSA level plus 2 ng/mL, were at greater risk of dying of prostate cancer. The new study confirms those results using a multinational database and shows that the measure is ready for use in the clinic.
"Now we can use the simple criteria from this study, which is widely available for anyone who has PSA testing, to identify men who have a greater than 25% chance of dying from prostate cancer in the next five years. That is huge. There is nothing else that can do that," says Buyyounouski.
A total of 2,132 men with clinically localized prostate cancer who suffered biochemical failure after treatment were studied. The median interval between treatment and biochemical failure was 35.2 months for the entire study group. However, 19% of patients developed biochemical failure at 18 months or less. The five-year cancer-specific survival for these men was 69.5% compared with 89.8% for men who developed biochemical failure after 18 months.
A multivariate analysis showed that the interval to biochemical failure correlated with cancer specific survival, as did Gleason score, tumor stage, age, and PSA doubling time. However, the interval to biochemical failure had the best predictive value for cancer-specific mortality, compared with the other variables.
Currently, most physicians do not start treatment based on biochemical failure alone, but rather wait until the PSA reaches a high level or there is some other evidence tumor spread. "The potential impact of this finding is that patients can initiate treatment far sooner without waiting for other signs or symptoms of prostate cancer," Buyyounouski says. "If a patient has biochemical failure at 16 months, rather than wait and learn later that the PSA is rising sharply and risk the development of distant metastasis, therapy can be started sooner based on the increased risk of death."
Source: Fox Chase Cancer Center
Articles on the same topic
- Radiation therapy after lumpectomy for breast cancer can be safely reduced to 4 weeksWed, 4 Nov 2009, 18:11:33 UTC
- 3-week course of breast radiation may be as effective as conventional 5- to 7-week course for early breast cancersWed, 4 Nov 2009, 18:11:32 UTC
- Does race, income predict prostate cancer outcome?Wed, 4 Nov 2009, 17:31:18 UTC
- Cancer patients want honesty, compassion from their oncologistWed, 4 Nov 2009, 17:31:15 UTC
- Shorter radiation course stops cancer growth in high-risk prostate cancer patientsTue, 3 Nov 2009, 18:26:31 UTC
- Shorter radiation course as effective as standard therapy for prostate cancer recurrenceTue, 3 Nov 2009, 18:26:29 UTC
- Radiation therapy technique successfully treats pain in patients with advanced cancerTue, 3 Nov 2009, 16:08:59 UTC
- PET imaging before radiation not ideal for determining boost radiation dosesTue, 3 Nov 2009, 15:46:33 UTC
- Obesity significantly increases side effects of stereotactic body radiation therapy in lung cancer patientsMon, 2 Nov 2009, 18:24:29 UTC
- Proton therapy is well-tolerated in prostate cancer patientsMon, 2 Nov 2009, 17:59:49 UTC
- Stereotactic radiotherapy stops lung cancer from growing in frail patientsMon, 2 Nov 2009, 17:44:13 UTC
- Stereotactic radiotherapy stops lung cancer from growing in frail patientsMon, 2 Nov 2009, 17:44:11 UTC
- Stereotactic radiotherapy offers noninvasive, effective treatment for lung cancer patientsMon, 2 Nov 2009, 17:44:10 UTC
- Adding proton therapy 'boost' to X-ray radiation therapy reduces prostate cancer recurrencesMon, 2 Nov 2009, 17:39:33 UTC
- Short-term hormone therapy and intermediate dose radiation increases survivial for early stage prostate cancerMon, 2 Nov 2009, 17:15:37 UTC
- Preventative brain radiation for lung cancer patients: Benefits and risksMon, 2 Nov 2009, 16:51:41 UTC
- Undetectable PSA after radiation is possible and predicts good patient outcomesMon, 2 Nov 2009, 16:33:07 UTC
- Additional, specialized radiation not necessary for some women after mastectomyMon, 2 Nov 2009, 16:33:05 UTC
- Real benefits vs. risks of preventative brain radiation for nonsmall cell lung cancer patientsMon, 2 Nov 2009, 16:33:04 UTC
- Radiation after surgery reduces chance of melanoma returningMon, 2 Nov 2009, 16:33:03 UTC
- Short-term hormone therapy added to radiation increases survival for medium-risk, but not low-risk, prostate cancer patientsMon, 2 Nov 2009, 16:33:00 UTC
Other sources
- Irradiated cancers stay downfrom Science AlertThu, 5 Nov 2009, 8:14:23 UTC
- Radiation therapy after lumpectomy for breast cancer can be safely reduced to 4 weeksfrom PhysorgWed, 4 Nov 2009, 21:28:05 UTC
- Cancer patients want honesty, compassion from their oncologistfrom PhysorgWed, 4 Nov 2009, 19:14:06 UTC
- Radiation therapy technique successfully treats pain in patients with advanced cancerfrom Science BlogTue, 3 Nov 2009, 21:07:19 UTC
- PET imaging before radiation not ideal for determining boost radiation dosesfrom PhysorgTue, 3 Nov 2009, 19:56:11 UTC
- Radiation Therapy Technique Successfully Treats Pain In Patients With Advanced Cancerfrom Science DailyTue, 3 Nov 2009, 17:21:13 UTC
- Radiation therapy technique successfully treats pain in patients with advanced cancerfrom PhysorgTue, 3 Nov 2009, 16:35:53 UTC
- Additional, specialized radiation not necessary for some women after mastectomyfrom PhysorgTue, 3 Nov 2009, 7:56:07 UTC
- Adding proton therapy 'boost' to X-ray radiation therapy reduces prostate cancer recurrencesfrom PhysorgTue, 3 Nov 2009, 4:56:07 UTC
- Proton Therapy Is Well-tolerated In Prostate Cancer Patientsfrom Science DailyTue, 3 Nov 2009, 4:14:07 UTC
- Stereotactic radiotherapy stops lung cancer from growing in frail patientsfrom PhysorgTue, 3 Nov 2009, 3:28:16 UTC
- Preventative brain radiation for lung cancer patients: Benefits and risksfrom PhysorgTue, 3 Nov 2009, 3:28:14 UTC
- Proton therapy is well-tolerated in prostate cancer patientsfrom PhysorgTue, 3 Nov 2009, 1:14:18 UTC
- Undetectable PSA after radiation is possible and predicts good patient outcomesfrom PhysorgTue, 3 Nov 2009, 0:07:19 UTC
- Radiation after surgery reduces chance of melanoma returningfrom PhysorgMon, 2 Nov 2009, 22:56:16 UTC
- Obesity significantly increases side effects of stereotactic body radiation therapy in lung cancer patientsfrom PhysorgMon, 2 Nov 2009, 21:49:15 UTC
- Preventative brain radiation for lung cancer patients: Benefits and risksfrom Science BlogMon, 2 Nov 2009, 18:49:09 UTC
- Short-term hormone therapy and intermediate dose radiation increases survivial for early stage prostate cancerfrom PhysorgMon, 2 Nov 2009, 17:42:15 UTC
- Stereotactic Radiotherapy Offers Noninvasive, Effective Treatment for Frail Patients with Early-stage Lung Cancerfrom Newswise - ScinewsMon, 2 Nov 2009, 17:42:07 UTC
- Undetectable PSA After Radiation Is Possible And Predicts Good Patient Outcomesfrom Science DailyMon, 2 Nov 2009, 17:21:30 UTC
- Radiation After Surgery Reduces Chance Of Melanoma Returningfrom Science DailyMon, 2 Nov 2009, 16:28:58 UTC