Tuesday, December 07, 2010

Prostate Cancer Staging Can't Predict Recurrence

Prostate Cancer Staging Can't Predict Recurrence

 One of the first things that a man wants to know after he has been diagnosed with prostate cancer is the cancer’s stage, which is supposed to indicate the extent of the disease and help predict the likelihood of recurrence after treatment.

But when it comes to localized or non-spreading prostate cancer, staging may not be an important predictor of recurrence after the prostate gland is removed, a study shows.The findings are published online in the journal Cancer.

Localized prostate cancer is staged as T1-T2, but there are several problems with the system. The stage is based on your doctor's estimate of the extent of the prostate cancer. This assessment is based on the results of a physical exam, lab tests, biopsy, and imaging tests.

In the new study, researchers analyzed data on 3,875 men who were diagnosed with localized prostate cancer at 40 urology practices between 1995 and 2008. They found that doctors improperly staged the cancer 35.4% of the time.

Even after researchers corrected for these inaccuracies, the stage still did not correlate with risk of recurrence after removal of the gland, a procedure called radical prostatectomy.

Predicting Prostate Cancer Recurrence

There appear to be several problems with our current clinical staging criteria for prostate cancer.

But there are several other variables available to the practitioner at the time of diagnosis which are strongly associated with prostate cancer recurrence after radical prostatectomy.

These variables include prostate-specific antigen (PSA) levels. PSA is a protein produced by cells of the prostate gland that can be elevated in the blood of men who have prostate cancer.

Other important variables include the tumor’s Gleason score or grade and the percent of positive biopsy cores or the number of cancerous cells taken during the prostate biopsy.

These variables seem to be more powerful predictors of recurrence than clinical stage. These data should be emphasized in preoperative counseling and less weight should be placed on clinical stage data.

Clinical stage is still important for prostate cancers that have spread outside of the prostate gland.

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