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Senior Citizen Health & Medicine
PSA of Prostate Cancer Victims Can Predict How Long
They Will Survive
Patients with lower PSA levels 7 months after
therapy lived longer
By Nicole Fawcett,
University of Michigan Health System
August 25, 2006 - A test used to detect prostate
cancer can also help doctors know when treatment is working. A mans
prostate specific antigen, or PSA, level after seven months of hormone
therapy for advanced prostate cancer predicted how long he would
survive, according to a new multicenter study conducted by the Southwest
Oncology Group and led by researchers at the University of Michigan
Comprehensive Cancer Center.
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By Nicole Fawcett
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August 15, 2006 - More than half of men with
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The study evaluated 1,345 men with prostate cancer
that had spread to distant parts of the body. The men were treated with
seven months of androgen deprivation therapy, a treatment designed to
block the effects of hormones on the cancer. PSA levels were monitored
throughout the treatment. The researchers found that men whose PSA
dropped below 4.0 ng/ml had a quarter the risk of dying compared to
those whose PSA was more than 4.0.
Our analysis showed that a low or undetectable PSA
after seven months of androgen deprivation therapy is a powerful
predictor of risk of death in patients with new metastatic prostate
cancer. This could allow oncologists to identify patients who are
unlikely to do well with this treatment long before they develop
clinical signs of treatment resistance, says lead study author Maha
Hussain, M.D., professor of internal medicine at the U-M Medical School.
The researchers found 69 percent of the men
maintained a PSA level of less than 4.0 ng/ml after seven months of
treatment and 43 percent had an undetectable level of PSA at that time.
Patients whose PSA was higher than 4.0 at the end of seven months
survived 13 months, while patients whose PSA dropped below 4.0 but above
0.2 lived 44 months and those whose PSA was undetectable, below 0.2 ng/ml,
lived 75 months.
The men in the study were enrolled in a Phase III
SWOG trial in which they would receive additional treatment after the
seven months of initial hormone therapy. That study seeks to accrue
1,512 men. The patients PSA level before beginning treatment must be at
least 5.0 ng/ml to qualify for the study.
A PSA test measures the level in the blood of
prostate specific antigen, an enzyme produced by the prostate gland. It
is generally used as an initial screening test to detect prostate
cancer.
What is attractive about using PSA to predict
survival in metastatic prostate cancer is that it is an easily
measurable factor. These findings could help patients avoid ineffective
treatment and could help researchers design further trials, Hussain
says.
Some 234,460 men will be diagnosed with prostate
cancer this year, and 27,350 will die from it, according to the American
Cancer Society. For more information about prostate cancer, call U-Ms
Cancer AnswerLine at 800-865-1125 or
click here.
In addition to Hussain, study authors were
Catherine Tangen, Southwest Oncology Group; Celestia Higano, Puget Sound
Oncology Consortium in Seattle; Paul Schelhammer, Devine-Tidewater
Urology in Norfolk, Va.; James Faulkner, Southwest Oncology Group; E.
David Crawford, University of Colorado Health Science Center; George
Wilding, University of Wisconsin Hospital and Clinics; Atif Akdas,
Marmara University Hospital in Istanbul, Turkey; Eric J. Small,
University of California, San Francisco; Bryan Donnelly, Prostate Cancer
Institute in Calgary, Canada; Gary MacVicar, Northwestern University;
and Derek Raghavan, Cleveland Clinic Foundation.
Funding for the study was from the National Cancer
Institute.
Results of the study appear in the Aug. 20 issue of
the
Journal of Clinical Oncology.
Reference: Journal of Clinical Oncology, Vol. 24, issue 24, pp.
3984-3990
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