When planning for treatment, radiation oncologists evaluate the pretreatment PSA (prostate specific antigen) because it is a strong predictor of the patient's outcome following radiotherapy. The pretreatment PSA is used to determine the appropriate radiotherapy dose and whether androgen deprivation therapy should be given. Doctors say evaluating a patient's PSA level after surgical removal of some prostate tissue with a TURP, which is often done for men who have an enlarged prostate with significant urinary symptoms unrelated to prostate cancer, is not an accurate picture of disease progression.
"PSA is secreted from both normal and cancerous tissue," explained lead author David J. D'Ambrosio, M.D., a resident in the radiation oncology department at Fox Chase Cancer Center. "Patients who have had a TURP prior to their prostate cancer treatment may have lower pretreatment PSA levels because there is less prostate tissue remaining. This can mislead physicians regarding the extent of disease." D'Ambrosio said that men with a PSA level of 10 to 20 likely would have had a PSA of greater than 20 if they did not have surgery to remove their some of their prostate, and therefore would have received more aggressive treatment.
The Fox Chase study evaluated 1,287 men with low to intermediate risk with a similar stage of disease. All had a pretreatment PSA of less than 20 and received 3D conformal radiotherapy without hormone (androgen deprivation) therapy. Of these, 143 men had a prior TURP. The median pretreatment PSA was 7.3 (range: 0.1-19.9). The number of men wi
Contact: Karen C. Mallet
Fox Chase Cancer Center