Discoveries
Joint study shows that monitoring PSA testing over time is key step for predicting prostate cancer risk
For more than a decade, the prostate-specific-antigen (PSA) test has been a way for doctors to gauge prostate cancer risk. Men whose PSA levels, measured by a simple blood test, rose above a specific level were considered likely to harbor cancer cells within their prostate gland.
Prostate cancer cells.
A new study by researchers at Dana-Farber and Brigham and Women's Hospital is challenging that approach. The investigators found that the rate at which PSA levels rise may be more important for predicting the danger of prostate cancer than the PSA levels themselves. (PSAs are proteins produced by the prostate gland in the male reproductive system.)
The study, published in the New England Journal of Medicine, used data from more than 1,000 retirement-age men who had had their cancerous prostate glands surgically removed. The researchers showed that patients who had large PSA increases in the year before surgery probably had more aggressive forms of cancer, since they died at a higher rate than other patients, even after their prostates were removed. The results suggest that monitoring PSA changes over time—tracking the "PSA velocity"—will help physicians assess which patients are at particular risk for prostate cancer and can most benefit from aggressive therapy.
"These findings provide solid evidence that annual PSA testing over a period of time is a reliable indicator," says study lead author Anthony D'Amico, MD, PhD, a radiation oncologist at DFCI and Brigham and Women's. "We hope the results will encourage physicians to measure 'baseline' PSA levels of men at age 35, then monitor them through their 40s to determine risk and appropriate treatment if the cancer appears. As with mammograms, this test should be done yearly to catch the disease when it is curable."
