80s rock star shares remarkable treatment update: How he went ...
PSA Levels After Prostate Cancer Treatment May Not Predict Survival Rate
Not all cancer treatments and testing are the same in how they improve a patient's long-term survival — especially with prostate cancer.
A research team from the University of California Los Angeles has determined that using PSA level recurrence to determine overall survival may not be the best indicator of feeling better or living longer.
The study was published in the Journal of Clinical Oncology on August 28.
The continued detection of PSA, or prostate-specific antigen, levels after treatment of prostate cancer may not have a great impact on understanding a person's overall survivability despite it being a tool used in early prostate cancer detection.
PSA, or prostate-specific antigen, is a protein that is made by both normal and malignant cells in the prostate.
Biochemical recurrence is the idea that after prostate cancer treatment, some cancer cells survive and can cause increases in PSA.
This rise in PSA can indicate that the cancer has either not gone away entirely or has reemerged — despite a patient not having any symptoms.
"In other words, a patient is found to have a PSA blood level that suggests that their prostate cancer has returned, but on imaging and scans, there is no evidence of any cancer anywhere in the body — this generally happens when the amount of cancer is too small for our current imaging to detect," said Dr. Ruchi Talwar, Urologic Oncology Fellow at the Vanderbilt University Medical Center in Nashville, Tennessee. Talwar was not part of the study.
The UCLA research team analyzed data from 11 trials including 10,741 patients. The researchers looked at biochemical recurrence in these prostate cancer patients to understand if there was a correlation between this reoccurrence, treating this recurrence, and overall survivability.
While recurrence, in theory, seems to be a promising marker to understand if cancer has come back, evidence is lacking to show that this is useful in predicting the overall survivability of patients with prostate cancer.
The study authors note that biochemical recurrence should not be considered a primary endpoint when creating therapies for prostate cancer.
Rather, when creating therapies, "metastasis-free survival remains an appropriate endpoint for prospective trials related to radiation therapy in localized disease," according to the study.
Talwar explains, "PSA blood tests are one tool that doctors can use to screen for prostate cancer."
Prostate-specific antigen is a protein that is produced by the prostate gland. Even in a healthy prostate, a PSA level is detectable. However, in cases when PSA rise, it gives clinicians cause for concern that there may be cancer or there may be multiplying cells within the prostate.
If a person is diagnosed with prostate cancer, some men will undergo radiation or even surgery to treat this condition.
"PSA [as] a biomarker of treatment response is actually incredibly useful and is one of the best markers in oncology — especially since all reoccurrences are associated with a rise in PSA," said Dr. Amar Kishan, associate professor of radiation oncology at the David Geffen School of Medicine at UCLA and senior author of the study.
Traditionally after therapy for prostate cancer, PSA levels decrease dramatically to hopefully undetectable levels.
"After treatment, PSA blood tests are used to monitor for prostate cancer[ recurrence] which means return of active cancer after treatment, and in some specific situations, PSA blood [tests]are used to determine if extra treatment is required, such as radiation treatment soon after surgery," Talwar explained to Healthline.
In routine follow-up, the next step would be to undergo imaging studies. But, it is not always visible on imaging and the rise in PSA can be one of the first markers of recurrence.
Two primary therapies used after biochemical recurrence are salvage radiation therapy and androgen deprivation therapy.
Salvage radiation therapy is a treatment that has the goal of localized control to prevent and delay metastasis through radiation therapy.
Androgen deprivation therapy or hormonal injections can be used decrease the PSA level.
However, it is not known if those shots help people live longer. Additionally, they can cause side effects like thinning their bones and even increase the risk of diabetes.
Talwar explains that "PSA surveillance can be an important tool" but it is certainly not perfect. She advises and recommends further research in this space to help further understand its utilization.
Kishan relates that not all recurrences are lethal.
He says that using the information from his study can help not only design clinical trials but also understand endpoints and what it may mean for survivability.
Many of the studies that surround biochemical recurrence relate to survivability. However, quality of life is another metric that should be examined, but most studies have not looked at this end point.
A new study from a research team from the University of California Los Angeles has determined that using PSA level recurrence to determine overall survival may not be the best indicator of feeling better or living longer.
Dr. Rajiv Bahl, MBA, MS, is an emergency medicine physician, board member of the Florida College of Emergency Physicians, and health writer. You can find him at RajivBahlMD.
Prostate Cancer Screening
Prostate cancer typically takes years to manifest and in most men, the cancer advances slowly. However, prostate cancer is one of the largest killers among men worldwide.
Screening for cancer is an important part of patient care and aims to diagnose cancer at an early stage before symptoms begin and while there is a greater chance of treating and curing the cancer. Currently, there is no national screening programme for prostate cancer in the UK but men who visit their doctor concerned about prostate cancer may be offered the following tests.
Digital rectal examination (DRE)This may be performed by a nurse or doctor who checks for abnormalities in the prostate gland such as areas of irregularity, hardness, or increased size. The doctor or nurse uses their finger to feel the prostate gland through the wall of the rectum.
Since the rectum lies behind the prostate gland, it may be felt by the finger through the front wall of the rectum. The procedure does not usually take long or feel painful but it may be a bit uncomfortable. In the case of benign prostatic hyperplasia (BPH), the gland feels enlarged but smooth and firm, while in prostate cancer the gland may feel hard and lumpy.
Blood tests for prostate-specific antigen (PSA) levelPSA is a protein that is secreted by the prostate gland. PSA is normally present in a man's blood and the level increases with age, but in the case of prostate cancer, the levels may be significantly raised. This test, however, is not specific for prostate cancer and a high PSA level can be caused by infection, benign prostate enlargement or even physical activity or sex.
UltrasoundIf an abnormality is detected through DRE or PSA assessment, a doctor may order an ultrasound scan which uses sound waves to generate an image of the prostate gland that can be evaluated. A biopsy is also performed in which a sample of cells are taken from the prostate and sent for laboratory analysis to confirm whether cancer is present or not.
If any of the screening tests reveal the early stages of prostate cancer, a treatment approach called watchful waiting or active surveillance is often adopted. If the cancer is not causing symptoms and is slow growing and localized to a small area of the prostate, watchful waiting with regular monitoring of the cancer is considered a safe approach. Such monitoring involves blood PSA checks, further DREs and ultrasounds scans performed at regular intervals (usually every 3 to 6 months) to check for growth of the cancer.
SourcesLung Cancer News
Dec. 1, 2022 — About 80% of people with cancer suffer from significant muscle wasting, or loss of muscle tissue, and 30% of these patients die from this condition. New research in mice finds that the severity of ...
Nov. 29, 2022 — While it may seem common knowledge that smoking is bad for your lungs, if and how ultrafine particles present in cigarette smoke impact the development and progression of lung cancer remains unclear. ...
Nov. 15, 2022 — Airway inflammation and emphysema are more common in marijuana smokers than cigarette smokers, according to a new study. Researchers said the difference may be due to the way that marijuana is smoked ...
Nov. 8, 2022 — Scientists investigating the mechanics of the early stages of lung cancer have identified a new potential treatment, which could also aid early detection of the disease. Levels of a key protein -- ...
Oct. 25, 2022 — A new study has revealed significant racial disparities in how quickly minorities with the most common form of lung cancer receive potentially lifesaving radiation therapy compared with their white ...
Oct. 6, 2022 — This year, about 200,000 people will be diagnosed with non-small-cell lung cancer, the second leading cause of death after cardiovascular disease. Researchers are working to improve the odds for ...
Sep. 28, 2022 — Despite significant advances, mortality from brain tumors remains high with five-year survival rates of 36%. More accurate diagnoses might improve the situation, but tissue biopsies are invasive and ...
Sep. 21, 2022 — The majority of the socioeconomic disparity, or deprivation gap, in cancer incidence could have been prevented in England between 2013 and 2017 if nobody had smoked, according to a new ...
Sep. 16, 2022 — In Germany, about ten per cent of all children are born before the 37th week of pregnancy and are thus considered premature. Many of these premature babies require help with breathing due to their ...
Sep. 13, 2022 — Researchers used extensive single-cell analysis to create a spatial map of tumor-infiltrating B cells and plasma cells in early-stage lung cancers, revealing new roles for these immune cells in ...
Sep. 13, 2022 — A new mechanism has been identified through which very small pollutant particles in the air may trigger lung cancer in people who have never smoked, paving the way to new prevention approaches and ...
Sep. 1, 2022 — About 30,000 cases of lung cancer occur in Spain each year. Mutations in KRAS oncogenes account for 10-15% of these cases, a subgroup against which there are still no effective therapies. Researchers ...
Aug. 31, 2022 — An experimental combination of two drugs halts the progression of small cell lung cancer, the deadliest form of lung cancer, according to a study in ...
Aug. 9, 2022 — More females than males who have never smoked have lung cancer and increasing evidence indicates that air pollution may be a major risk factor for these ...
July 20, 2022 — Scientists have found that using immunotherapy alongside a drug that blocks a common gene mutation in lung cancer could be a promising new combination therapy for certain types of lung tumors. Their ...
July 18, 2022 — Researchers have found a new way to track metastatic cancer cells in the body, which in the future could help identify cancer earlier and give patients more treatment ...
July 14, 2022 — Treatment for lung cancer has improved in recent years, and a new study has found how to make it even more effective for all ...
July 12, 2022 — Offering intensive, weekly telephone-based cessation counseling along with nicotine replacement for people who smoke and who were undergoing screening for lung cancer resulted in over a two-fold ...
June 14, 2022 — A study shows a strong relationship between prolonged exposure to low levels of radon and lung cancer, indicating a need for enhanced protection measures. Radon gas in the air decays into tiny ...
June 3, 2022 — Nearly 43% of patients with non-small cell lung cancer (NSCLC) whose lung cancers harbored a specific KRAS mutation responded to the experimental drug adagrasib, and the targeted agent also showed ...
Thursday, December 1, 2022
Tuesday, November 29, 2022
Tuesday, November 15, 2022
Tuesday, November 8, 2022
Tuesday, October 25, 2022
Thursday, October 6, 2022
Wednesday, September 28, 2022
Wednesday, September 21, 2022
Friday, September 16, 2022
Tuesday, September 13, 2022
Thursday, September 1, 2022
Wednesday, August 31, 2022
Tuesday, August 9, 2022
Wednesday, July 20, 2022
Monday, July 18, 2022
Thursday, July 14, 2022
Tuesday, July 12, 2022
Tuesday, June 14, 2022
Friday, June 3, 2022
Thursday, June 2, 2022
Tuesday, May 17, 2022
Wednesday, May 4, 2022
Tuesday, May 3, 2022
Monday, April 25, 2022
Wednesday, April 20, 2022
Tuesday, April 19, 2022
Monday, April 11, 2022
Thursday, April 7, 2022
Wednesday, March 30, 2022
Thursday, March 24, 2022
Wednesday, March 16, 2022
Thursday, February 24, 2022
Thursday, February 3, 2022
Wednesday, February 2, 2022
Wednesday, January 12, 2022
Friday, January 7, 2022
Thursday, December 16, 2021
Monday, December 13, 2021
Thursday, December 9, 2021
Tuesday, November 2, 2021
Thursday, October 14, 2021
Wednesday, October 6, 2021
Thursday, September 30, 2021
Tuesday, September 28, 2021
Thursday, September 23, 2021
Monday, September 20, 2021
Thursday, September 16, 2021
Tuesday, September 14, 2021
Monday, September 6, 2021
Friday, September 3, 2021
Monday, August 23, 2021
Thursday, August 12, 2021
Tuesday, August 3, 2021
Thursday, July 29, 2021
Tuesday, July 13, 2021
Thursday, July 8, 2021
Monday, June 28, 2021
Tuesday, May 18, 2021
Tuesday, May 11, 2021
Wednesday, March 24, 2021
Wednesday, March 10, 2021
Thursday, February 4, 2021
Wednesday, January 27, 2021
Tuesday, January 26, 2021
Thursday, January 21, 2021
Thursday, January 14, 2021
Wednesday, December 30, 2020
Monday, December 14, 2020
Thursday, November 19, 2020
Tuesday, November 17, 2020
Friday, October 16, 2020
Friday, September 25, 2020
Thursday, September 17, 2020
Tuesday, September 1, 2020
Comments
Post a Comment