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Study Defines Parameters for Catching Prostate Cancer Earlier


— July 18, 2024

Researchers seek to improve prostate cancer detection, intervention, and survival rates.


New research published in European Urology Oncology studied patients diagnosed with prostate cancer in an effort to develop more effective treatment options, leading to better prognoses overall. Prostate cancer can be an especially deadly disease and many men are at risk of being diagnosed at some point in their lifetimes.

In 2024 alone, nearly 300,000 of new cases of prostate cancer are expected to be diagnosed in the United States and an estimated 35,250 men are expected to die from the disease. One in 6-8 men are at risk of being diagnosed with this cancer, which carries a five-year survival rate (99% in the early stages and 34% for late stage). Black men are also 1.7 times more likely to be diagnosed compared to Caucasian men and they are 2.1 times more likely to die from it.

The team used the Gleason score, a system ranging from 6 to 10, to analyze patients with prostate cancer. A lower score on the scale means that cancer cells still closely resemble normal ones and are likely to spread slowly with higher numbers representing cells that are more mutated and likely to spread quickly. The team biopsied participants to determine their score, and subsequently measure disease progression and risk of mortality.

Study Defines Parameters for Catching Prostate Cancer Earlier
Photo by Anna Tarazevich from Pexels

The ProtecT trial, a previous prostate cancer clinical trial with findings that have been met with criticism. This study included randomizing patients with GGG 1 disease to active monitoring (AM) or radical treatment, such as androgen deprivation therapy (ADT), radical prostatectomy (RP), or radiotherapy (RT). As much as 61% of the patients assigned to active monitoring eventually underwent radical treatment within 15 years. This fact highlights that earlier interventions might have been beneficial even for those originally diagnosed with a Gleason score of 1.

The new study, which builds upon the previous results, focused on determining clinical parameters that could help more accurately predict higher risks of severe prostate cancer and mortality among patients initially diagnosed with GGG 1. The team reviewed data from the 10,228 patients involved in the previous research who underwent RP for biopsy-diagnosed GGG 1.

The new analysis found that patients with GGG 1 prostate cancer who had a PPB greater than 50% or a PSA level over 20 ng/ml were at significantly higher risk for adverse pathology at RP and early PSA failure. These patients also had a higher risk of prostate cancer-specific mortality (PCSM).

The results suggest that patients with the clinical risk factors studied in the latest trial should be carefully monitored and might benefit from earlier and more aggressive treatment options. The team is recommending that patients with biopsy-diagnosed GGG 1 prostate cancer who display PPB over 50% or PSA levels exceeding 20 ng/ml undergo a follow-up biopsy to ensure that higher-grade and higher-stage cancers are detected and treated right away.

Prostate cancer is so deadly because it often develops slowly and individuals who have it may not experience any symptoms in the disease’s early stages. However, as it progresses, men might experience difficulty urinating, a weak or interrupted urine flow, frequent urination, blood in the urine or semen, erectile dysfunction, and pain or discomfort in the pelvic area.

Proactive screening is critical because it can detect the presence of prostate cancer before it becomes symptomatic or in the early stages when symptoms are first noticed. Early detection greatly increases the chances of successful treatment and can lead to longer life expectancy rates.

Sources:

Mortality Risk for Patients with Biopsy Gleason Grade Group 1 Prostate Cancer – European Urology Oncology

Can the Gleason score be predicted in patients with prostate cancer? A dynamic contrast-enhanced MRI, (68)Ga-PSMA PET/CT, PSA, and PSA-density comparison study

Gleason Score Evolution and the Effect on Prostate Cancer Outcomes

Gleason Score: Grading System for Prostate Cancer

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