Researchers at Johns Hopkins and The Brady Urological Institute have identified three risk factors and developed a simple reference tool that doctors can use to determine who is at high risk of death after prostate cancer recurrence following surgery. The new tool - a set of tables that assess a combination of blood tests, the surgical pathology results and time following surgery - can be used to tell which men with recurring cancer after surgery are most likely to die from their renewed disease and would benefit from further treatment.
"We identified three risk factors associated with death from prostate cancer after recurrence that may allow doctors to distinguish early on between those who need further treatment versus those who are relatively safe and can be carefully watched," says Stephen J. Freedland, M.D., instructor of urology at Johns Hopkins and lead investigator of the report published in the July 27, 2005, issue of the Journal of the American Medical Association.
If discovered early through screening, prostate cancer is treatable and is often cured by a surgical procedure called radical prostatectomy. However, as many as one-third of those who undergo surgery will eventually show signs that the cancer has recurred, said Freedland.
The risk factors are based on:
- The amount of time, in months, it takes the level of prostate-specific antigen (PSA) in the blood to double after surgery. The shorter the time, the higher the risk.
- The elapsed time, in years, from surgery to recurrence as measured by the PSA test. Again, the shorter the time the higher the risk.
- The Gleason score (2-10), a microscopic measurement of prostate cancer aggressiveness when viewed under a microscope. Higher scores reflect more aggressive tumors.
An additional finding was that time to death after recurrence for patients in the low-risk group was quite long -- often much longer than 16 years, added Freedland.
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Contact: Trent Stockton
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