Dr. Marc Garnick, Editor in Chief
Is PSA reliable?
That's a good question, because having an elevated PSA doesn't necessarily mean that a man has prostate cancer.
One couple's story: Handling prostate cancer in the face of differing biopsies
Elliot and Elizabeth Boyd share their experience with a prostate cancer diagnosis, explain their next steps in light of seemingly contradictory test results, and offer advice to those coping with their diagnosis and weighing treatment options. Read more »
Following surgery to remove a cancerous prostate gland, some men experience a biochemical recurrence, meaning that prostate-specific antigen (PSA) has become detectable in their blood. Since only the prostate releases PSA, removing the gland should drop this protein to undetectable levels in the body. Detecting PSA could signify that prostate cancer cells are lingering, and […]Read more »
Charles Schmidt A pair of new studies provides useful information to men facing challenging decisions about what to do after being diagnosed with early prostate cancer. Researchers tracked men for 10 years and found that virtually none died of the illness, even if they decided against treating it. Early prostate tumors confined to the prostate […]Read more »
New research has shaken up a time-honored strategy for treating advanced prostate cancer that’s begun to metastasize, or spread. Doctors ordinarily treat these cases with systemic therapies designed to kill off metastatic tumors appearing throughout the body. But they don’t use local therapy to treat the primary tumor in the prostate. That’s because the primary tumor — unlike the metastases that it spawns — is rarely lethal. So doctors have been reluctant to give local therapy, such as radiation to the prostate or surgery to remove the organ, if it’s not going to improve the odds of survival. Now investigators are turning that assumption on its head. According to their findings, men who received local therapy while being treated for metastatic prostate cancer lived longer than those who didn’t, “and that makes a case for being more aggressive in how we manage patients who present with metastatic disease,” said Dr. Chad Rusthoven, a radiation oncologist and assistant professor at the University of Colorado School of Medicine in Denver, and the study’s first author.Read more »
Suspicious findings from prostate cancer screening are often followed by a procedure most men would prefer to avoid: a prostate biopsy. But what if biopsies actually could be avoided on the basis of non-invasive test results? Screening tests are moving in that direction, with some intriguing results. One of them, the Prostate Health Index blood test, combines measures of three forms of prostate-specific antigen (PSA) into a score that helps doctors predict if a cancer is likely to progress, with an aim to circumvent biopsies that aren’t necessary.Read more »
Men diagnosed with slow-growing prostate tumors that likely won’t be harmful during their lifetimes can often avoid immediate treatment. Instead, they can have their tumor monitored using a strategy called active surveillance. With this approach, doctors perform periodic checks for tumor progression and start treatment only if the cancer begins to metastasize, or spread. Active […]Read more »
Hormonal therapy, also known as androgen-deprivation therapy, can be a powerful weapon in the fight against prostate cancer because it deprives malignant cells of the fuel they need to grow. Androgens — meaning the family of male sex hormones that includes testosterone — contribute to physical characteristics such as a deeper voice, thick facial hair, and increased muscle strength and bone mass. But when prostate cancer develops, testosterone also contributes to tumor growth and progression. Depending on the specific treatment used, hormonal therapy can either stop the body from making testosterone or prevent it from interacting with cancer cells.Read more »
It’s well known that defective BRCA genes can increase a woman’s chances of developing breast, ovarian, and other cancers. But these same gene changes can also increase a man’s risk of dying from prostate cancer. Now, a new study published in The New England Journal of Medicine has shown that men with prostate cancer who […]Read more »
Fewer men are being given PSA tests to screen for prostate cancer. As screening rates have fallen, so have the number of prostate cancer diagnoses. This probably also means that fewer men are receiving potentially unnecessary treatment, with its attendant negative side effects. At the same time, it isn’t yet clear whether that comes at the cost of more aggressive cancers being caught at an incurable stage. Better screening tests may make the difference in helping strike the right balance between limiting harm and preventing prostate cancer deaths.Read more »
A new study confirms that active surveillance is a safe and reasonable alternative to immediate treatment for prostate cancer. In recently published study that followed 1,300 men, the prostate cancer survival rate after 10-15 years of active surveillance, was 99%. For some men, a strong discomfort with “living with cancer” may steer them away from postponing treatment in favor of careful monitoring.Read more »
Treatment decisions are complicated for men with low-risk prostate cancer that grows slowly. These cancers may never become deadly during a man’s expected lifespan. And there is no conclusive evidence showing that treatment in these cases extends survival. So cancer specialists have been leaning toward monitoring low-risk prostate cancer carefully and starting treatment only when it begins to spread. This approach was once used only in academic cancer centers, but new research suggests that this strategy is becoming more common in urology practices throughout the United States and other countries as well.Read more »